Gallstone ileus is a rare cause of mechanical bowel obstruction seen in patients with a history of cholelithiasis or cholecystitis. Its diagnosis is difficult since it presents vague and nonspecific symptoms. This is the case of a 69-year-old woman with a history of arterial hypertension and type 2 diabetes mellitus, without a surgical history, who is admitted to the emergency room due to abdominal pain. Her diagnosis is based on contrast X-ray images, computed tomography (CT) and upper gastrointestinal endoscopy. Surgery remains being the gold standard treatment.
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