We present a case of a large bowel obstruction secondary to a large impacted gallstone measuring 5cm in the sigmoid colon. Significant features include a cholecysto-colonic fistula and the presence of a perforation initially missed on imaging. Endoscopic retrieval was attempted, followed by a Hartmann's procedure. This case highlights the significance of operative management in ensuring the safe treatment of colonic gallstone ileus, especially in a rural setting.

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http://dx.doi.org/10.7759/cureus.78475DOI Listing

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