Although the efficacy of long-term indwelling endoscopic gallbladder stent (EGBS) has been established in recent years, we report here a case of gallstone ileus that developed under the presence of indwelling EGBS. An 84-year-old female visited her local clinic due to right abdominal pain that had lasted for 3 days. Ultrasonography revealed a gallbladder stone and the gallbladder swelling. Accordingly, she was referred to our hospital, where we detected a 5-cm stone impacted in the gallbladder neck on imaging, and we admitted the patient with a diagnosis of acute cholecystitis. As it was difficult to secure a puncture route for percutaneous transhepatic gallbladder drainage we performed endoscopic retrograde cholangiopancreatography to place EGBS through the papilla. The patient progressed favorably after the procedure and was discharged on hospital day 10. Although the patient was followed up without cholecystectomy, 3 months later, she was transported to the hospital by ambulance with abdominal pain and vomiting. A CT scan revealed that the gallbladder stent had fallen into the ileocecal region and a gallstone was impacted in the ileum, causing gallstone ileus. After admission, we initiated treatment by placing an ileus tube and removed the gallstone by ileotomy after the ileus improved. The patient progressed well postoperatively and was discharged on hospital day 42 of the second hospitalization.
