Gallstone obstruction and perforation of the duodenal bulb.

A case of gallstone ileus is presented in which the stone became impacted in the first part of the duodenum and then caused perforation at the site of impaction. This is only the second published British case of gallstone impaction at this site. Perforation of the duodenum by a gallstone has not previously been recorded. The clinical and radiological features of this case are discussed.