Rashad Khazen MD, Yaniv Shilo MD, Eyal Gal MD, Guy Pines MD
Gallstone ileus is an uncommon complication of cholelithiasis. It accounts for less than 1–4% of all small bowel obstructions [1]. The condition involves the passage of a gallstone into the gastrointestinal tract through a biliary-enteric fistula, often resulting in obstruction at the ileum or, less commonly, the duodenum. This condition is known as Bouveret syndrome [1]. Management can be surgical (gastrotomy, intragastric laparoscopy, pyloromyotomy, duodenotomy, enterotomy) or endoscopic (removal with nets/baskets, electrohydraulic lithotripsy [EHL], extracorporeal shockwave lithotripsy [ESWL]). Endoscopic management is preferred due to its lower morbidity and mortality rates [2,3].