Biliary ileus is due to the enclosure of a biliary calculus, having migrated through a bilio-digestive fistula. We report the case of a patient admitted for a sub-occlusive syndrome. The abdominal CT scan showed hydroaeric distension of the gallbladder upstream of a large obstructive stone in an ileal loop. Median laparotomy reveals a large stone straddling the jejunum and the ileum, an umbilicated vesicular bed on a scleratrophic vesicle intimately adherent to the supra duodenal genus. After intestinal emptying, a longitudinal enterotomy is performed in front of the stone, which is extracted by digital expression, then a transverse enteroplasty is performed according to the Mickulicz technique.

Keywords : Biliary ileus; bilio-digestive fistula; Mickulicz technique;