Gallstone ileus in the Jordanian Royal Medical Services in a 10-year period

Six patients [5 women and 1 man, with a median age of 71 years] were operated on for gallstone ileus in the 10-year period 1988-98. The diagnosis was made before operation in 2 patients. The obstructing stones were located in the terminal ileum in 3 patients and in the proximal ileum or jejunum in 3 patients. Choledochoduodenal fistula was present in all patients. A single-stage procedure [removal of the impacted stone, fistula repair and cholecystectomy]was performed in 1 patient, enterolithotomy alone in 4 patients and resection of part of the intestine where the stone was impacted with primary anastomosis performed in 1 patient. In the postoperative period, 2 patients developed infection of the wound and 2 patients developed deep vein thrombosis; 1 of these died of pulmonary embolism.