Abstract
A nonagenarian female admitted with epigastric pain and fever. She had a past history of common duct stone which had been treated by EST. Abdominal CT scan revealed a huge common duct stone causing dilatation of the common bile duct. Conservative treatment was chosen, according to the patients preference. Abdominal CT scan was performed, according to the appearance of nausea and vomiting. The CT scan showed a gallstone which had moved from the common bile duct into the short bowel, causing short bowel obstruction. We diagnosed it as gallstone ileus and inserted the long intestinal tube for treatment. No improvement was shown on the seventh day after insertion, so operation was considered. To confirm the location of the gallstone, abdominal CT scan was performed just before surgery. It revealed no short bowel obstruction, and revealed that the gallstone had moved into the rectum, therefore the operation was canceled. We report an elderly case of gallstone ileus which successfully recovered by conservative treatment. Evaluation by CT scan when clinical changes are seen, seemed to be useful for gallstone ileus to determine treatment plans including operation, especially in elderly patients.
