title: An intriguing case of gallstone ileus after hepaticojejunostomy caused by a "stone on a suture".
abstract: Gallstone ileus (GI) is a mechanical obstruction of small or large bowel caused by gallstone passed to the intestinal lumen through spontaneous or postoperative biliodigestive fistula. A 42-year-old female patient was admitted with the clinical presentation of small bowel obstruction. She underwent hepaticojejunostomy 4 years prior to admission for primary sclerosing cholangitis. Barium meal follows through revealed Rigler's triad. The patient underwent laparotomy which revealed GI. A "stone on a suture" was removed through enterotomy. Patients after cholecystectomy and hepaticojejunostomy can develop GI. Nonabsorbable suture used to create biliodigestive anastomosis can appear to become the frame of a "stone on a suture."
authors.affiliation: Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia.
authors.forename: Mahir
authors.initials: M
authors.lastname: Gachabayov
authors.affiliation: Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia.
authors.forename: Petr
authors.initials: P
authors.lastname: Mityushin
keywords: Bouveret's syndrome; enterolithotomy; gallstone ileus; hepaticojejunostomy; small bowel obstruction