Gallstone ileus with acute renal failure

The most common complications of gallstone disease include acute cholecystitis, acute pancreatitis, choledocholithiasis with or without cholangitis, and a gangrenous gallbladder. Other uncommon complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus (1). Gallstone ileus accounts for 1%-3% of all patients who require surgery for intestinal obstruction. Among those over 65 years of age, however, the prevalence of gallstone ileus is much higher, accounting for 25% of nonstrangulated small bowel obstruction.The associated morbidity and mortality rates are high, in part, because of the age of the typical patient and concomitant medical conditions .The diagnosis of gallstone ileus is difficult, usually depending on the radiographic findings. In 50% of cases the diagnosis is often only made at laparotomy (2). Gallstone ileus must be considered in intestinal obstruction patients that sonography revealed inflammatory changes of gallbladder, especially in elderly females. Abdominal CT is the preferred modality because of its rapid diagnosis of gallstone ileus.