Recurrent gallstone ileus due to a residual gallstone: A case report and literature review

INTRODUCTION: Mechanical small bowel obstruction is an uncommon but important complication of cholelithiasis. Recurrent gallstone ileus has historically been considered a rare occurrence; however, the incidence is likely to be underreported and the condition carries a high mortality rate. PRESENTATION OF CASE: We present a case in which a 67 year old man suffered a recurrence of gallstone ileus 10 days after his initial enterolithotomy, requiring further laparotomy. DISCUSSION: We review the literature to highlight potential clinical predictors as well as the benefits and pitfalls of management options in preventing repeated episodes of gallstone ileus in the same patient. CONCLUSION: The presence of multifaceted gallstones and multiple stones of size >= 2cm on pre-operative imaging should alert the clinician to potential for recurrence. (C) 2015 The Authors. Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.