PMC5122189_01
(a) Plain abdominal film showed intestinal obstruction (air-fluid levels) and pneumobilia (shown with arrow), (b) barium follow through after 6 h showed intestinal obstruction and pneumobilia (shown with arrow), (c) barium follow through after 12 h showed Rigler's triad: Pneumobilia (shown with arrow), intestinal obstruction (air-barium levels), and ectopic gallstone (shown with 4 arrows)
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F1
Plain abdominal X-ray revealed small bowel air-fluid levels and pneumobilia [Figure 1]. The first control X-ray after 6 h showed the presence of small bowel obstruction, the second control X-ray after 12 h revealed Rigler's triad, thus proving the diagnosis of GI [Figure 1].
Intraoperative findings, (a) the gallstone is located, (b) enterolithotomy
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F2
Enterotomy with gallstone removal was performed [Figure 2].
Extracted gallstone, (a) the "stone on a suture," (b) the gallstone is fragmented, (c) nonabsorbable polypropylene suture making the frame of the gallstone
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F3
The gallstone itself was very interesting so that it was formed on a polypropylene nonabsorbable suture probably used for hepaticojejunal anastomosis [Figure 3].