ACUTE intestinal obstruction by gall-stones is uncommon. Vick (1936) gives a figure of 0.7 per cent of all cases of obstruction, and in the great majority of these the stone impacts in the small intestine.
T h e percentage of stones impacting in the large bowel is small.
Grey Turner (1932) describes in a personal series of 10 operations for gall-stone obstruction-in itself a remarkable number for one surgeon in view of the rarity of the condition-8 with stones impacted in small and 2 (20 per cent) in large intestine, but Foss and Summers (1942), in a series of 150 (140 from the literature from 1922 to 1942, with 10 cases of their own), found that obstruction occurred in the duodenum in 6, .jejunum i n 14, ileum in 125, and rectum in 2, while in only 3 (2 per cent) was the impaction in the colon.
Here it should be noted that some stones after signs of attempted obstruction or after a silent passage are passed per anum.
Mortality is high: 50 per cent is a generally agreed figure. Foss and Summers (1942) quote 50 per cent, Vick (1936) 50-60 per cent, and Rigler, Borman, and Noble (1941) 50 per cent.
On account therefore of this high mortality and the rarity of colonic obstruction by stone, and in view too of some interesting features, this case is thought to be worthy of record.
CASE REPORT
Mrs. E. M., aged 75, was admitted to Hove General Hospital in the afternoon of March 2, 1949.
She gave a history of ten days' intermittent diarrhaa and constipation, with pain tending to increase over this period. Enemata produced small amounts of flatus or fzces, but little relief.
Temperature 99-100 and pulse 100. On further inquiry she admitted some mild attacks of indigestion " for some time ".