Gallstone ileus with concomitant cholecystoduodenal and cholecystocolonic fistulae: surgical management with enterolithotomy, fenestrating partial cholecystectomy, and primary fistula repair – a case report
- 1Department of General Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- 2Department of Surgery, Leratong Hospital, Johannesburg, South Africa
Abstract
Introduction and importance:: Gallstone ileus with concomitant cholecystoduodenal and cholecystocolonic fistulae is rare. This report describes the successful one-stage surgical management of a high-risk patient without preoperative computed tomography (CT) imaging.
Case presentation:: A 46-year-old morbidly obese woman (BMI >45 kg/m2) with atrial fibrillation presented with symptoms of bowel obstruction for more than 2 weeks. Despite complete mechanical small-bowel obstruction, she had no perforation or ischemia. The diagnosis was confirmed by plain radiographs and an oral contrast study; CT was deferred because of acute kidney injury.
Clinical discussion:: At laparotomy, a large obstructing gallstone was found in the distal ileum together with a second large stone in the gallbladder at the fistula site. A single-stage procedure (enterolithotomy, fenestrating partial cholecystectomy, and primary repair of both fistulae) was performed. The patient recovered well and was discharged on postoperative day 12.
Conclusion:: This case illustrates that definitive one-stage surgery can yield good short-term outcomes in carefully selected high-risk patients with dual fistulae and a residual stone when clinical and basic imaging findings are concordant, even without cross-sectional imaging.
Related
- Surgeons and Experts’ Perspectives in Concomitant Bariatric Surgery with Cholecystectomy: Bari-Chole Egypt Survey
- Cholecystocolonic fistula with ruptured cystic artery pseudoaneurysm presenting as massive per rectal bleeding: a case report
- Mini-Laparotomy Enterolithotomy for Gallstone Ileus in an Elderly Patient: A Case Report.
- Elective cholecystectomy benchmarks: nationwide registry study
- Development and Internal Validation of a Preoperative Risk Stratification Model for Difficult Laparoscopic Cholecystectomy in Acute Cholecystitis
BibTeX
@article{mohamed2026gallstone,
title = {{Gallstone ileus with concomitant cholecystoduodenal and cholecystocolonic fistulae: surgical management with enterolithotomy, fenestrating partial cholecystectomy, and primary fistula repair – a case report}},
author = {Mozamil Mohamed and Khomotsho Lekala and Bisola M. Adewuyi and Etshumang Daniel Molefe},
journal = {International Journal of Surgery Case Reports},
year = {2026},
month = oct,
doi = {10.1097/rc9.0000000000001084},
url = {https://doi.org/10.1097/rc9.0000000000001084},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Gallstone ileus with concomitant cholecystoduodenal and cholecystocolonic fistulae: surgical management with enterolithotomy, fenestrating partial cholecystectomy, and primary fistula repair – a case report
AU - Mozamil Mohamed
AU - Khomotsho Lekala
AU - Bisola M. Adewuyi
AU - Etshumang Daniel Molefe
PY - 2026
DA - 2026/10/06
JO - International Journal of Surgery Case Reports
DO - 10.1097/rc9.0000000000001084
UR - https://doi.org/10.1097/rc9.0000000000001084
AB - Introduction and importance:: Gallstone ileus with concomitant cholecystoduodenal and cholecystocolonic fistulae is rare. This report describes the successful one-stage surgical management of a high-risk patient without preoperative computed tomography (CT) imaging. Case presentation:: A 46-year-old morbidly obese woman (BMI >45 kg/m2) with atrial fibrillation presented with symptoms of bowel obstruction for more than 2 weeks. Despite complete mechanical small-bowel obstruction, she had no perforation or ischemia. The diagnosis was confirmed by plain radiographs and an oral contrast study; CT was deferred because of acute kidney injury. Clinical discussion:: At laparotomy, a large obstructing gallstone was found in the distal ileum together with a second large stone in the gallbladder at the fistula site. A single-stage procedure (enterolithotomy, fenestrating partial cholecystectomy, and primary repair of both fistulae) was performed. The patient recovered well and was discharged on postoperative day 12. Conclusion:: This case illustrates that definitive one-stage surgery can yield good short-term outcomes in carefully selected high-risk patients with dual fistulae and a residual stone when clinical and basic imaging findings are concordant, even without cross-sectional imaging.
SN - 2210-2612
ER -