Pathophysiology, Diagnosis, and Treatment of Colonic Gallstone Ileus in an Elderly Patient

Gallstone ileus is a rare entity, and an obstructing gallstone in the left colon is even less frequent. A 78-year-old man was evaluated for abdominal distension and pain, associated with a lack of bowel movements in the past 5 days. An abdominal computed tomography showed a cholecystocolonic fistula associated with a gallstone in the descending colon. During the operation, the gallstone was retrieved through a longitudinal colotomy proximal to the impaction site, which was then closed.