Double gallstone ileus.

Background: Gallstone ileus remains a rare but important cause of intestinal obstruction.

Methods: We present a unique case of two gallstones causing intestinal obstruction at the same time.

Results: A 90-year-old lady presented with signs and symptoms of small bowel obstruction. At operation, two gallstones stuck at different points within the bowel were causing the obstruction and were removed.

Conclusions: When operating on patients with small bowel obstruction from gallstone ileus, examination of the entire small bowel should be considered mandatory.