Laparoscopic management for gallstone ileus, case report

•Gallstone ileus is a rare cause of small bowel obstruction usually in elderly females.•Surgery is the mainstay treatment without a clear consensus about the best approach.•This female underwent an uneventful total laparoscopic management of gallstone ileus.•Laparoscopic enterolithotomy is safe, feasible and effective when performed by experienced surgeons. Gallstone ileus is a rare complication of cholelithiasis leading to small intestinal obstruction. Elderly females are commonly affected more than male. The diagnosis of this condition is challenging and Rigler’s triad is pathognomonic. Surgery is mandatory with no clear consensus about the best surgical approach that should be adopted. An elderly female patient, with no previous history of biliary diseases, presented with small bowel obstruction. Contrast enhanced computed tomography of the abdomen showed the classical Rigler’s triad. Total laparoscopic enterolithotomy was performed successfully. She had smooth postoperative course and she was followed up regularly without occurrence of any biliary disease symptoms during the follow up period. Gallstone ileus should be considered in differential diagnosis of small bowel obstruction mainly in old females with no previous history of abdominal surgery. Laparoscopic enterolithotomy is safe, feasible and effective when performed by experienced surgeons.