A case of gallstone ileus caused by obstruction of some gallstones with a cholecystoduodenal fistula

A 68-year-old man was admitted to our hospital due to abdominal pain and nausea. Abdominal computed tomography showed the 30 mm gallstone obstructed the transverse part of the duodenum. Therefore, gallstone ileus with a cholecystoduodenal fistula was diagnosed. During treatment, the 32 mm stone in the gallbladder moved to the transverse part of the duodenum. We tried to crush and remove the stones using mechanical lithotripsy, however the procedure was unsuccessful. Therefore, a laparoscopic surgery was performed, and approximately two 45 mm gallstones were removed from the ileum. Considering the size and number of stuck gallstones, this case is difficult to remove the gallstones with endoscopic treatment. Here, we describe the treatment of the gallstone ileus with a cholecystoduodenal fistula, with a review of the literature.