Biliary Ileus

  • Benoit Navez
  • Hwai-Ding Lam
  • Jean-François Gigot


Gallstone ileus (also known as biliary ileus), a rare complication of cholelithiasis, is defined as a mechanical intestinal obstruction due to a gallstone lodging in the intestinal lumen. This entity was first described by the Danish physician Thomas Bartholin in 1654 during an autopsy [1]. The average age of occurrence is about 70 years old. The youngest case reported was a 13 year old patient and the eldest patient was 97 years old [2]. About 85% of patients are women. Gallstone ileus accounts for 1–2% of all causes of mechanical intestinal obstruction but should be always considered whenever small bowel obstruction is encountered in an elderly patient [3].


Small Bowel Obstruction Gallbladder Carcinoma Gastric Outlet Obstruction Gallstone Ileus Plain Abdominal Radiograph 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Martin F (1912) Intestinal obstruction due to gallstones. Ann Surg 55:725PubMedCrossRefGoogle Scholar
  2. 2.
    Kasahara Y, Umemura H, Shiraha S et al (1980) Gallstone ileus. Review of 112 patients in the Japanese literature. Am J Surg 140:437–440PubMedCrossRefGoogle Scholar
  3. 3.
    Jones PF (1987) Emergency abdominal surgery, 2nd edn. Blackwell scientific publicationsGoogle Scholar
  4. 4.
    Reisner RM, Cohen JR (1994) Gallstone ileus: a review of 1001 reported cases. Am Surg 60:44–446Google Scholar
  5. 5.
    Abou-Saif A, Al-Kawas FH (2002) Complications of gallstone disease: Mirrizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol 97:249–254PubMedCrossRefGoogle Scholar
  6. 6.
    Clavien PA, Richon J, Burgan S et al (1990) Gallstone ileus. Br J Surg 77:737–742PubMedCrossRefGoogle Scholar
  7. 7.
    Atli AO, Coskun T, Ozenc A et al (1997) Biliary enteric fistulas. Int Surg 82:280–283PubMedGoogle Scholar
  8. 8.
    Day EA, Marks C (1975) Gallstone ileus. Review of the literature and presentation of thirty-four new cases. Am J Surg 129:552–558PubMedCrossRefGoogle Scholar
  9. 9.
    Cushieri, Steele, Moosa (2002) Essential surgical practise, 4th edn AJ2Google Scholar
  10. 10.
    Lobo DN, Jobling JC, Balfour TW (2000) Gall-stone ileus: diagnostic pitfalls and therapeutic successes. J Clin Gastroenerol 30:72–76CrossRefGoogle Scholar
  11. 11.
    Bouveret L (1896) Stenose du pylore adherent à la vesicule. Rev Med (Paris) 16:1–16Google Scholar
  12. 12.
    Halaz NA (1964) Gallstone obstruction of the duodenal bulb (Bouveret’s syndrome) Am J Dig Dis 9:856–861CrossRefGoogle Scholar
  13. 13.
    Togeron SA, Greening GK, Juniper K et al (1979) Gallstone obstruction of duodenal cap (Bouveret’s syndrome) diagnosed by endoscopy. Am J Gastroenterol 72:165–167Google Scholar
  14. 14.
    Murphy GD (1995) Bouveret’s syndrome. Am J Gastroenterol 90:638–639Google Scholar
  15. 15.
    Ariche A, Czeiger D, Gortzak Y et al (2000) Gastric outlet obstruction by gallstone: Bouveret syndrome. Scand J Gastroenterol 35:781–783PubMedCrossRefGoogle Scholar
  16. 16.
    Masannat Y, Caplin S, Brown T (2006) A rare complication of a common disease:Bouveret syndrome, a report of a case. World J Gastroenterol 12:2620–2621PubMedGoogle Scholar
  17. 17.
    Sica GS, Sileri P, Gaspari AL (2005) Laparoscopic treatment of Bouveret’s syndrome presenting as acute pancreatititis. JSLS 9:472–475PubMedGoogle Scholar
  18. 18.
    Masannat Y, Masannat Y, Shatnawei A (2006) Gallstone ileus: a review. Mt Sinai J Med 73:1132–1134PubMedGoogle Scholar
  19. 19.
    Courvosier LT (1890) Zasurstich-Statistische Beiträge zur pathologie und chirurgie der gallenwege. Leipzig, FCW VogelGoogle Scholar
  20. 20.
    Cooperman AM, Dickson RE, ReMine WH (1968) Changing concepts in the surgical treatment of gallstone ileus: a review of 15 cases with emphasis on diagnosis and treatment. Ann Surg 167:377–383PubMedCrossRefGoogle Scholar
  21. 21.
    Salah-Eldin AA, Ibrahim MA, Alapati R et al (1990) The Bouveret syndrome: an unusual cause of hematemesis. Henry Ford Hosp Med J 38:52–54PubMedGoogle Scholar
  22. 22.
    Heinrich D, Meier J, Wehrli H et al (1993) Upper gastrointestinal hemorrhage preceding development of Bouveret’s syndrome. Am J Gastroenterol 88:777–780PubMedGoogle Scholar
  23. 23.
    Mulholland MW, Lillemoe KD, Doherty GM et al (2006) Greenfield’s surgery scientific principles and practise, 4th edn. Philadelphia, Lippincot Williams & WilkinsGoogle Scholar
  24. 24.
    Galloway AC, Shires GT, Daly JM et al (1999) Principles of surgery by Schwartz, 7th edn, New York, McGraw HillGoogle Scholar
  25. 25.
    Rigler LG, Borman CN, Noble JF (1941) Gallstone obstruction: pathogenesis and roentgen manifestations JAMA 117:1753–1759Google Scholar
  26. 26.
    Balthazar EJ, Schrechter LS (1978) Air in gallbladder: a frequent finding in gallstone ileus. AJR Am J Roentgenol 131:219–222PubMedGoogle Scholar
  27. 27.
    Yu CY, Lin CC, Shyu RY et al (2005) Value of CT in the diagnosis and management of gallstone ileus. World J Gastroenterol 11:2142–2147PubMedGoogle Scholar
  28. 28.
    Doko M, Zovak M, Kopljar M et al (2003) Comparison of surgical treatment of gallstone ileus: preliminary report. World J Surg 27:400–404PubMedCrossRefGoogle Scholar
  29. 29.
    Kirchmayr W, Muhlmann G, Zitt M et al (2005) Galstone ileus: rare and still controversial. ANZ J Surg 75:234–238PubMedCrossRefGoogle Scholar
  30. 30.
    Soto DJ, Evan SJ, Kavic MS (2001) Laparoscopic management of gallstone ileus. JLJS 5:279–285Google Scholar
  31. 31.
    Sarli L, Costi R, Gobbi S (1998) Gallstone ileus: laparoscopic assisted enterolithotomy. J Am Coll Surg 186:370–371PubMedCrossRefGoogle Scholar
  32. 32.
    Moberg AC, Montgomery A (2007) Laparoscopically assisted or open enterolithotomy for gallstone ileus. Br J Surg 94:53–57PubMedCrossRefGoogle Scholar
  33. 33.
    Ferraina P, Gancedo MC, Elli F et al (2003) Video-assisted laparoscopic enterolithotomy: new technique in the surgical management of gallstone ileus. Surg Laparosc Endosc Percutan Tech 13:83–87PubMedCrossRefGoogle Scholar
  34. 34.
    Montgomery A (1993) Laparoscope-guided enterolithotomy for gallstone ileus. Surg Laparosc Endosc 3:310–314PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Benoit Navez
    • 1
  • Hwai-Ding Lam
    • 1
  • Jean-François Gigot
    • 2
  1. 1.Department of Abdominal SurgeryHospital Saint JosephCharleroi (Gilly)Belgium
  2. 2.Division of Hepatobiliary and Pancreatic Surgery Department of Abdominal Surgery and TransplantationSaint-Luc University HospitalBrusselsBelgium

Personalised recommendations