Gallstone Ileus: Clinical Presentation and Radiological Diagnosis

Shruti Gaikwad; Mandar Marathe

doi:10.7759/cureus.42059

Case Report Emergency Medicine & Radiology

Gallstone Ileus: Clinical Presentation and Radiological Diagnosis

Shruti Gaikwad, Mandar Marathe

Cureus, 15(7), e42059 · 2023 · doi:10.7759/cureus.42059

Cited by 14+ (per Google Scholar, Aug 2026 — check live count)

Plain-language summary

A case report of a woman in her 80s presenting with vague abdominal pain and an inability to open her bowels, ultimately diagnosed with gallstone ileus — a rare form of bowel obstruction caused by a gallstone that erodes through the gallbladder wall and lodges further down the bowel. The report walks through the diagnostic reasoning, centred on the classic “Rigler's triad” of CT findings that clinches the diagnosis.

Why this matters

Gallstone ileus is uncommon (1–4% of bowel obstructions) but carries a mortality rate above 25% when missed, precisely because its symptoms are vague and mimic more common conditions. This case serves as a teaching example for emergency physicians and radiologists on recognising the CT pattern early, while there is still time for surgery.

Published abstract

The term “gallstone ileus” refers to intestinal obstruction brought on by a gallstone lodged within its lumen. The gallstone travels through a fistula that develops because of the constant pressure it exerts on the gall bladder. The symptoms are vague and confounding, which can commonly lead to delay in diagnosis. The preferred imaging technique is a computed tomography scan. The diagnosis is confirmed by the identification of Rigler's Triad on a CT scan, which includes a small intestinal obstruction, pneumobilia, and an ectopic stone in the intestine. The condition is associated with several complications and needs to be treated with emergency surgery. This case demonstrates how a patient could have non-specific symptoms and how early detection by imaging was crucial to the patient's treatment.

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Keywords

gallstone ileus Rigler's triad intestinal obstruction CT scan cholelithiasis

Cite this publication

Gaikwad S, Marathe M. Gallstone Ileus: Clinical Presentation and Radiological Diagnosis. Cureus. 2023;15(7):e42059. doi:10.7759/cureus.42059

Gaikwad, S., Marathe, M. (2023). Gallstone Ileus: Clinical Presentation and Radiological Diagnosis. Cureus, 15(7), e42059. https://doi.org/10.7759/cureus.42059

@article{GaikwadS2023,
  author = {Shruti Gaikwad and Mandar Marathe},
  title = {Gallstone Ileus: Clinical Presentation and Radiological Diagnosis},
  journal = {Cureus},
  year = {2023},
  doi = {10.7759/cureus.42059},
  volume = {15},
  number = {7},
  pages = {e42059}
}

TY  - JOUR
AU  - Shruti Gaikwad
AU  - Mandar Marathe
PY  - 2023
TI  - Gallstone Ileus: Clinical Presentation and Radiological Diagnosis
JO  - Cureus
VL  - 15
IS  - 7
SP  - e42059
DO  - 10.7759/cureus.42059
UR  - https://doi.org/10.7759/cureus.42059
ER  -

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