Hepatobiliary surgery: gallstone ileus: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary surgery: gallstone ileus

Sample item

An older patient has small-bowel obstruction, pneumobilia, and an ectopic gallstone on imaging. Which diagnosis is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Gallstone ileus

Gallstone ileus occurs when a gallstone enters bowel through a bilioenteric fistula and obstructs the intestine. The combination of obstruction, pneumobilia, and ectopic stone is Rigler triad.

Option by option

  • A. Ulcerative colitis

    Ulcerative colitis is inflammatory colitis, not mechanical obstruction by a stone.

  • B. Gallstone ileus (correct)

    Correct. This imaging triad is characteristic of gallstone ileus.

  • C. Acute appendicitis

    Appendicitis does not cause pneumobilia and ectopic gallstone.

  • D. Mesenteric adenitis

    Mesenteric adenitis is usually a self-limited inflammatory condition.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Gallstone ileus. Gallstone ileus occurs when a gallstone enters bowel through a bilioenteric fistula and obstructs the intestine.

Why is "Ulcerative colitis" not the answer?

Ulcerative colitis is inflammatory colitis, not mechanical obstruction by a stone.

Why is "Acute appendicitis" not the answer?

Appendicitis does not cause pneumobilia and ectopic gallstone.

Why is "Mesenteric adenitis" not the answer?

Mesenteric adenitis is usually a self-limited inflammatory condition.

What concept does this question test?

It tests Hepatobiliary surgery: gallstone ileus in General Surgery. The combination of obstruction, pneumobilia, and ectopic stone is Rigler triad.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary surgery: gallstone ileus?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.