Gallstone ileus. The importance of contrast examinations in the roentgenographic diagnosis.

Our experience based on the analysis of 12 proved cases of gallstone ileus is presented emphasizing the fact that the plain abdominal roentgenogram may be inconclusive or deceiving. It allowed us to suggest the correct diagnosis in only 4 cases. A high index of suspicion, particularly in elderly female patients, followed by barium examination of the upper gastrointestinal tract leads to a correct and rapid diagnosis. The demonstration of a diverticulum-like structure or a fistulous tract adjacent to the first portion of the duodenum associated with jejunal dilatation and barium dilution is highly reliable.