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An 83-year-old woman was admitted to the hospital with abdominal pain. Three months prior to this, she had been admitted for a gallbladder stone associated with acute cholecystitis, which was medically managed, the symptoms improved. At this admission, plain abdominal X-ray showed an obstruction in the small bowel. Abdominal computed topography (CT) scan revealed a large gallstone in the distal ileum and dilated loops of the small bowel. The patient was assessed to have gallstone ileus in the ileum and surgical treatment was planned. Between the time of diagnosis and the planned procedure, the abdominal pain spontaneously improved. Follow up abdominal CT scan showed that the gallstone had migrated to the distal rectum. We removed the large gallstone by sigmoidoscopy and with the physician's two fingers. The extracted gallstone was 3.5¡¿3.0¡¿3.0 cm in size. This is the first reported case in South Korea of an impacted gallstone in the ileum spontaneously passed with consequent non-surgical recovery.(Korean J Med 70:S184-S189, 2006)
Key Words : Gallstone, Ileus |
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