Hepatobiliary Surgery — MCQs

Q: Most common site for impaction of gallstones in gallstone ileus is:

Terminal ileum. ***Terminal ileum*** - The **terminal ileum** is the narrowest part of the small bowel, making it the most common site for **gallstone impaction** in gallstone ileus. - Due to a combination of its relatively small lumen and its position at the **end of the small intestine**, large gallstones are most likely to become lodged here, causing obstruction. *First part of duodenum* - The **duodenum**, especially the first part, has a relatively **wide lumen** and is typically not a site of impaction for gallstones causing ileus. - While the fistula often forms here, the stone usually **passes distally** without obstruction at this point. *Second part of duodenum* - Similar to the first part, the **second part of the duodenum** is wide and designed for chyme propulsion, making impaction here less common. - Gallstones typically move quickly through the duodenum into the **jejunum** and **ileum**. *Colon* - The **colon** has a much larger diameter than the small intestine, making gallstone impaction unlikely unless the stone is exceptionally large or there is pre-existing stricture. - Though very rarely, a gallstone may pass into the colon via a **cholecystocolonic fistula**, but obstruction is still rare due to the wide lumen.

Practice by Chapter

Liver Anatomy and Physiology

Practice Questions

Benign Liver Lesions

Practice Questions

Liver Abscess

Practice Questions

Hepatocellular Carcinoma

Practice Questions

Metastatic Liver Disease

Practice Questions

Cirrhosis and Portal Hypertension

Practice Questions

Liver Trauma

Practice Questions

Cholelithiasis and Cholecystitis

Practice Questions

Choledocholithiasis

Practice Questions

Biliary Tract Tumors

Practice Questions

ERCP and Its Complications

Practice Questions

Liver Transplantation Basics

Practice Questions

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free

Scan to download app