A 78-year-old man with no history of prior abdominal surgery presented with complete small bowel obstruction. The flat plate shows dilated jejunum (note plicae semicircularis) only (ileum is smooth walled), indicating a mid-small bowel obstruction.
The gallbladder contained several partially opaque gallstones. A diagnosis of gallstone ileus was considered, but there was no calcification elsewhere in the abdomen and no air in the biliary tree.
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