[Management of small bowel obstruction caused by a gallstone].

Bowel obstruction caused by a gallstone is a rare pathology in the abdomen. The high mortality associated with this condition has prompted the authors to present their experience over the past two years against the background of published case reports. This paper presents three different ways of management of gallstone ileus: enterolithotomy; two-stage surgery--enterolithotomy followed by cholecystectomy; one-stage surgery--enterolithotomy combined with cholecystectomy and fistula repair. The authors report on a case which was successfully managed with enterolithotomy only and discuss arguments in favor of each procedure. Enterolithotomy appears to be the safest approach in gallstone ileus, leaving time to qualify the patient for further surgery on the basis of clinical status and symptoms.