Cholelithiasis

Patient with a history of cholelithiasis and multiple past episodes of right upper quadrant pain who presents with acute abdominal distention and diffuse colicky abdominal pain. Axial and coronal CECT demonstrates cholelithiasis with a calcified gallstone within the small bowel lumen and minimal small bowel dilation proximal to the obstructing stone. Additionally, there is air within the gallbladder lumen, like from a fistulous connection between the gallbladder and duodenum. Sensitivity and specificity of MDCT in the diagnosis of gallstone ileus is approximately 93% and 100%, respectively.