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An abdominal computed tomographic scan may help in confirming the diagnosis by showing the gallbladder thickening, pneumobilia, intestinal obstruction, and gallstone.2 The standard treatment of gallstone ileus is enterolithotomy performed by longitudinal enterotomy proximal to the point of impaction, removal of the stone, then transverse closure of the enterotomy. In the past, most patients also underwent cholecystectomy in addition to enterolithotomy, but this practice has been abandoned owing to a significant increase in mortality.3 In conclusion, gallstone ileus occurs in elderly women with vague abdominal pain, vomiting, and a history of cholelithiasis.