GALLSTONE ILEUS 46 YEARS POST-CHOLECYSTECTOMY DUE TO DUODENAL DIVERTICULUM

Gallstone ileus is a rare cause of small bowel obstruction that is typically seen in older females with multiple comorbidities. Gallstone ileus is most commonly caused by the passage of a gallstone through a cholecystoduodenal fistula, in the setting of chronic cholecystitis, with stone impaction most frequently seen in the terminal ileum. We present a rare case of gallstone ileus in a 51 year old female that formed 4 decades after cholecystectomy, likely due to the presence of a small duodenal diverticulum. This case highlights the need for the inclusion of gallstone ileus in the differential diagnosis for patients presenting with bowel obstruction even after cholecystectomy.