PMC3015453_01
Plain abdominal radiograph of patient 1 demonstrates pneumobilia.
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F1
Plain radiographs of the abdomen demonstrated air in the biliary tree and dilated loops of small bowel in the left upper quadrant suspicious for gallstone ileus (Figure 1).
SBS of patient 1 demonstrates obstruction of the jejunum with a 7 x 5-cm mass (arrow 1) and reflux of contrast into the gallbladder (arrow 2) and biliary tree (arrow 3) via a cholecystoduodenal fistula.
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F2
The following morning, a small bowel series (SBS) with water-soluble contrast was obtained and demonstrated near complete obstruction of the proximal jejunum with a 7 x 5-cm mass (Figure 2) and reflux of contrast into the gallbladder and biliary tree.
6.3 x 4.5 x 4.2 cm gallstone extracted from the jejunum via a transverse enterotomy.
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F3
A 6.3 x 4.5 x 4.2 cm smooth, oval stone was extracted through a transverse enterotomy (Figure 3), which was repaired in two layers.
PMC3015453_02
Abdominal and pelvic CT of patient 2 demonstrates an oval-shaped, calcified mass obstructing the terminal ileum.
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F4
Computed tomography of the abdomen and pelvis demonstrated an oval-shaped, calcified mass near the terminal ileum with proximal small bowel dilatation (Figure 4).