Gallstone ileus is a rare complication of biliary disease (0.3-0.5%), representing 1 - 4% from the mechanical bowel obstruction, because of its impaction into bowel lumen after a biliary enteric fistula. We report a 88 year-old female patient who presented assintomatic biliary disease with this complication and needed urgent surgery, discussing the risks and the rates ofde morbi/mortality associaded with this kind of treatment. The diagnosis was based on clinical features, plain abdominal X ray, abdominal TC, laboratory exams and intestinal transit. An exploratory laparoscopy was performed and the biliar stone was removed from the small bowel. Enterotomy and enterorrhaphy were made, without choclecystectomy. The postoperative period had respiratory complications, sepses, developing in to death in the 20th post-operative day. We concluded that biliary diease can have severe complications, and for this reason we agree with those who perfomed the eletive choclecystectomy in patients with low surgical risks, independently of their ages.
Gallstones; Ileum; Cholecystectomy; Intestinal Obstruction; Laparotomy