Typically, gallstone ileus presents as unexplained gradual onset of small bowel obstruction. Rarely, the stone may traverse the small bowel and obstruct the large bowel. In both, pain, distension, constipation and vomiting are present to varying degrees. Additionally, a mass may be felt in the right upper quadrant.
Note that obvious distension is rare when obstruction occurs in the duodenum or jejunum.
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