Gastric outlet obstruction in the setting of acute cholecystitis

Acute cholecystitis is a rare cause of gastric outlet obstruction (GOO) and may manifest with nonspecific symptoms which may preclude or delay diagnosis. During the latter part of the 20th century, benign disease was responsible for most cases of GOO in adults with peptic ulcer disease accounting for up to 90% of these cases. Although precise estimates on GOO incidence and prevalence are lacking, as many as 2000 surgical operations were reportedly performed annually for GOO in the United States in the 1990s. We present clinical and imaging findings of a case of a 101-year-old woman with GOO resulting from extrinsic compression from a massively dilated gallbladder related to acute cholecystitis. In addition, we review other rare biliary causes of GOO.