Small bowel obstruction caused by the impaction of a gallstone within the lumen of the small intestine

Aetiology

• See Gallstones

Pathophysiology

• Gallstone enters the small intestine via a fistula between the gallbladder and duodenum

Clinical features

• Intermittent symptoms of nausea, vomiting, abdominal distension, and pain
• Eventually results in distal small bowel obstruction

Investigations

• AXR: demonstrates small bowel obstruction
• Ultrasound: shows biliary tract pathology
• CT: diagnostic

Management

• Urgent laparotomy to remove stone, interval cholecystectomy in 3 months