What is the recommended management of small bowel obstruction due to gallstone ileus?

The recommended management of small bowel obstruction due to gallstone ileus involves removing the obstructing gallstone and decompressing the small bowel. This approach is critical because gallstone ileus typically occurs when a gallstone passes through a fistula from the gallbladder to the gastrointestinal tract, often leading to an obstruction in the ileum.

Surgically addressing this condition generally includes performing a terminal ileal enterotomy, which involves making an incision in the bowel at the location of the obstruction to extract the gallstone. This not only allows for the removal of the obstructive stone but also helps relieve the resultant pressure and restore normal bowel function.

In contrast, simply observing the condition may not be appropriate due to the potential for complications such as bowel necrosis or perforation, which can arise from prolonged obstruction. Resecting the obstructed segment is often unnecessary unless there is evidence of compromise or extensive damage to the bowel. Administering laxatives is contraindicated in cases of obstruction, as they can exacerbate the situation rather than provide relief. Therefore, the correct management involves direct intervention to address both the stone and the obstruction, as outlined in the selected answer.