title: Gallstone ileus presenting as intussusception: A case report.
abstract: BACKGROUND
  Gallstone ileus is a complication of acute cholecystitis that accounts for 25% of bowel obstruction cases in the elderly. To our knowledge, only one other case of gallstone ileus presenting as intussusception has been reported in the literature, and involved non-operative management with an unfavorable outcome.
  
  
  METHODS
  Here we report the case of 69year old woman presenting with symptoms of acute small bowel obstruction with a surgical history significant for cholecystectomy 30 years prior. Computed tomographic imaging showed a target sign in the small bowel consistent with intussusception, but intraoperative diagnosis revealed this to be a gallstone. A simple enterolithotomy was conducted and the patient has since been symptom free.
  
  
  CONCLUSIONS
  Gallstone ileus has a high mortality rate (12-17%) and is an important differential diagnosis to consider, especially as the elderly population throughout the world continues to grow.
  
  
  CONCLUSIONS
  As radiographic features of gallstones are variable we suggest maintaining a high index of suspicion for gallstone ileus in any elderly patient presenting with SBO, even with a seemingly contradictory surgical history.
authors.affiliation: The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, USA. Electronic address: Rahul.Prasad@rockets.utoledo.edu.
authors.forename: Rahul M
authors.initials: RM
authors.lastname: Prasad
authors.affiliation: The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, USA.
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Weimer
authors.affiliation: The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, USA.
authors.forename: Arunkumar
authors.initials: A
authors.lastname: Baskara
keywords: Case report; Gallstone ileus; Geriatric surgery; Hepatobiliary; Intussusception; Small bowel obstruction