PAEA Surgery End Of Rotation (EOR) Practice Exam

Gallstone ileus is characterized by:

1. Obstruction of the bile duct

2. SBO from a gallstone eroding into the small bowel

3. A blockage in the pancreas

4. An inflammation of the gallbladder

The correct answer is: SBO from a gallstone eroding into the small bowel

Gallstone ileus is characterized by small bowel obstruction resulting from a gallstone that has eroded into the small intestine. Over time, chronic inflammation of the gallbladder can lead to a fistula formation between the gallbladder and the intestine. When a gallstone passes through this fistula, it can travel into the small bowel, causing a blockage. This condition is often seen in elderly patients with a history of gallstones. The obstruction in gallstone ileus typically occurs in the ileum, but it can happen anywhere in the small bowel. The presence of air in the biliary tree on imaging studies can also be an indicator of this condition. The focus is on the mechanism of obstruction due to the gallstone’s migration, distinguishing it from other forms of obstruction that involve different anatomical areas or causes, such as the bile ducts or the pancreas.