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1.  Twice recurrent gallstone ileus: a case report 
Introduction
Gallstone ileus is a rare cause of bowel obstruction and results from the passage of gallstones into the bowel.
Case presentation
We present the case of an 83-year-old Caucasian woman who had three episodes of gallstone ileus, each of which was managed with simple enterotomy. This sequence is one of the first reported in the medical literature and may be seen to challenge the traditional surgical approach of enterotomy alone.
Conclusions
The available evidence comparing enterotomy alone with combined enterotomy, cholecystectomy, and fistula closure in the management of gallstone ileus is reviewed. Neither approach is clearly identified as superior, but available series suggest that simple enterotomy may be safer than a combined approach and does not result in a higher rate of recurrent biliary disease.
doi:10.1186/1752-1947-6-362
PMCID: PMC3492071  PMID: 23095215
Recurrent gallstone ileus; enterotomy; fistulectomy

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