An intriguing case of gallstone ileus after hepaticojejunostomy caused by a “stone on a suture”

Gallstone ileus (gi) is a mechanical obstruction of small or large bowel caused by gallstone passed to the intestinal lumen through spontaneous or postoperative biliodigestive fistula. a 42-year-old female patient was admitted with the clinical presentation of small bowel obstruction. she underwent hepaticojejunostomy 4 years prior to admission for primary sclerosing cholangitis. barium meal follows through revealed rigler’s triad. the patient underwent laparotomy which revealed gi. a “stone on a suture” was removed through enterotomy. patients after cholecystectomy and hepaticojejunostomy can develop gi. nonabsorbable suture used to create biliodigestive anastomosis can appear to become the frame of a “stone on a suture”. © 2016 journal of research in medical sciences.