Gallstone ileus - An unusual presentation in an underweight older women

Gallstone ileus is an uncommon and peculiar complication of cholelithiasis in an older population. Perioperative mortality rates are high as this condition is difficult to diagnose, often lead to delay in treatment and high percentage older patients have multiple co-morbidities. Atypical presentations are common in older patients, most of who present to medical rather than surgical units, further delaying definitive treatment. We discuss a 79 year old female patient who presented with severe dehydration due to gastrointestinal symptom with no typical clinical signs of intestinal obstruction.