Abstract
Gallstone ileus (GI) occurs due to the migration of gallstones into the intestinal tract through a bilioenteric fistula. The surgical approach may vary based on the size and location of the fistula causing obstruction. We present a case of recurrent calculous cholecystitis with acute abdominal pain and vomiting, which was attributed to an uncommon giant gallstone located at the distal end of the duodenum. Our management involved performing a one-stage enterolithotomy, cholecystectomy, and fistula repair. The patient had an uneventful postoperative recovery without any complications such as duodenal leakage.