Gallstone ileus can be defined as mechanical intestinal obstruction due to intraluminal occlusion of bowel by a biliary calculus.1Although it was once thought to be a unique clinical entity, it is not so uncommon that the average surgeon has not observed at least one case. Bartholin was the first to record a case of cholecystoenteric fistula with entrance of a gallstone into the intestinal tract, in a patient examined at autopsy in 1654.2Courvoisier published the first article in 1890 in which he reported on 131 cases of gallstone ileus.3It is interesting to note that the mortality in the 125 operations which were performed for this condition was 44%. Since that time comprehensive reviews of the literature and recorded additional cases,4-7have augmented our understanding of this entity, as well as its proper management. It is the purpose of this report to review the