Gallstone ileus, a misnomer for intestinal obstruction due to impaction of a large gallstone in the intestine, has occurred 20 times in the Rhode Island Hospital since 1935. The purpose of this report is to study these cases with respect to diagnosis and treatment, and especially to attempt to determine whether definitive gallbladder surgery is necessary.
Age and Sex.
—The average age of the 20 patients in this series was 72. Ninety per cent were females. This correlates well with other reported series.
—Symptoms varied but were primarily those of obstruction. In those cases where the stone impacted in the more terminal portion of the bowel, the classic picture of low-bowel obstruction, with distention, obstipation, and finally vomiting, prevailed. In those cases where the stone impacted in the upper small bowel, the signs and symptoms were those of high obstruction but not necessarily of complete obstruction. Vomiting was