Biliary ileus
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A 71-year-old woman with a history of metabolic syndrome, asymptomatic gallstones, and metastatic breast cancer (treated with capecitabin) was referred to our hospital for nausea, vomiting, constipation and abdominal pain. On examination, her abdomen was moderately distended and tympanic and high-pitched bowel sounds were audible.Rectal examination was normal. CT showed liver metastasis, air-fluid levels in the small intestine, a biliary-enteric fistula and a large gallstone in the distal ileum...

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