Abstract
Gallstone ileus is a rare but significant cause of abdominal pain and mechanical bowel obstruction. Its management usually involves minimally invasive surgical intervention. This case report describes a 65-year-old woman with a history of Caroli disease and prior abdominal surgery, who presented with a one-month history of progressive, cramp-like abdominal pain, accompanied by nausea and intermittent vomiting. Due to these persistent symptoms, she underwent a CT scan, which confirmed gallstone ileus with obstruction of a jejunal loop, necessitating surgical removal of the gallstone. This case underscores the importance of integrating a patient's medical history with their presenting symptoms and maintaining a high level of clinical suspicion for rare but serious causes of mechanical bowel obstruction that may otherwise be overlooked.