Removal of a Gallstone Obstructing the Middle Ileum of a Woman With Nausea, Vomiting, and Abdominal Pain

A 70-year-old woman with hypertension, atrial fibrillation, congestive heart failure, and gallstones had 3 days of nausea, vomiting, and abdominal pain. She was diagnosed as having gallstone ileus based on clinical characteristics and findings on an abdominal computed tomography scan that showed a thickened gallbladder wall with intraluminal air adherent to the duodenum and a gallstone in the middle ileum with proximal bowel distension. This video shows the surgical removal of a 2.7-cm gallstone obstructing the middle ileum. Click the Related Article link for details.