Introduction:

Gallstone ileus is a mechanical obstruction of the gastrointestinal tract caused by the impaction of one or more gallbladder stones inside the intestinal lumen through a bilioenteric-fistula.

Clinical case:

A 59-year-old woman with multiple comorbidities, who went to the emergency room for intestinal obstruction, pneumobilea, and bowel distention is identified by image, so it was decided to enter the operating room for a probable biliary ileus and perform diagnostic laparoscopy, finding a 3.5 cm diameter lithium located in the terminal ileum.

Conclusion:

Gallstone ileus is a rare complication of cholelithiasis. The treatment integrates rehydration and a surgical approach to correct the cause of intestinal obstruction.