A 48-year-old woman presented to the emergency department complaining of a 2-day history of recurrent vomiting and abdominal pain. The patient has no hematemesis, hematochezia. During the last months, the patient presented to the emergency department several times due to right upper quadrant abdominal pain related to fatty foods consumption. Ultrasound found a 3-cm sized gallstone. On examination, the patient has a distended tympanic abdomen with increased bowel sounds. An abdominal x-ray shows air in the gallbladder tree. This patient's gallstone has been impacted at which of the following sites?

Question

Quizplus · Accepted Answer

Eductional Objective: Gallstone ileus is caused by a fistula formed between the intestinal tract and the gallbladder. The passage of the gallstone will obstruct the small intestines, at the narrowest point in the ileum. Patients affected present with small bowel obstruction and radiological images will present with pneumobilia.

A 48-Year-Old Woman Presented to the Emergency Department Complaining of a 2-Day