Rolling in the Deep: Imaging Findings and Diagnostic Pearls in Gallstone Ileus

Figure 13

Magnetic resonance imaging, fat-suppressed FIESTA axial sequence (a), SSFSE T2-weighted axial sequence (b), MIP-reformatted 3D-MRCP sequence (c), and unenhanced computed tomography of a patient with iodinate contrast media allergy treated for gallstone ileus with enterolithotomy. The fistulous communication (arrow in (a), (b), and (c)) between the gallbladder (white arrowhead in (a), (b), and (c)) and the duodenum (black arrowhead in (a), (b), and (c)) is readily visible in the MR images due to the presence of a small amount of fluid in its collapsed lumen. The CT study (d) could not provide an accurate fistula anatomy required by the abdominal surgeon to decide for a possible fistula repair.

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