Atypical Gallstone Ileus in a Young Adult: A Diagnostic Challenge and Surgical Resolution.

Gallstone ileus is a rare but serious complication of cholelithiasis resulting in mechanical bowel obstruction. We present the case of a 40-year-old woman with no prior medical history who developed classic features of gallstone ileus. Radiological investigations revealed Rigler's triad (small bowel obstruction, pneumobilia, ectopic gallstone), and the patient underwent exploratory laparotomy and enterotomy with successful extraction of multiple gallstones. Postoperative recovery was uneventful, and this case emphasizes the importance of early imaging and surgical intervention in such cases.