Gallstone ileus

Gallbladder is contracted with air foci inside(pneumobilia ) , obviously connected to the 2nd part of the duodenum ( gallbladder-duodenal fistula )

Dilated, fluid filled small bowel loops down to a calcified lesion  measures 23 x 36 mm at  the distal ileum (consistent with gallstone)  , collapsed  rest of ileum and the large bowel … features of mechanical small bowel obstruction due to gallstone at ileum (gallstone ileus ) .

Nondilated stomach and proximal duodenum (decompression), NG tube in situ.

Fluid density lesion at the region of the head 13 x19 mm