A 7 years old boy with chief complants of acute abdominal pain, fever, nausea and vomiting, was preoperatively diagnosed as acute appendicitis. However, it was postoperatively confirmed that the above distress were due to acute primary Mekel's diverticulitis. The size of the diverticulum was 8cm in length and 4cm in width. It was located at approximately 70cm above ileo-cecal junction. Macroscopically and histologically acute inflammatory changes were found. The patient was discharged on 7th hospital day with satisfactory convalescence.

Gallstone ileus can be defined as mechanical intestinal obstruction due to intraluminal occlusion by a biliary calculus. In most large series of intestinal obstruction, gallstone account for some 1 to 2 percent of all cases. In order to occlude the lumen of the intestine, the gallstone must be necessarily be large 1 inch (2.5cm) or more diameter. The commonest site for impaction of the gallstone is in the lower ileum, but the stone may lodge anywhere along the alimentary canal. The diagnoses should certainly be through of when an elderly female patient, giving a previous history of gallbladder disease, presents with features of intestinal obstruction. The four main radiological findings which are felt to be diagnostic are: 1) Air in the biliary tree 2) Dilated loops of small bowel 3) Demonstration of an opaque stone, especially if can be localized in the small bowel at the approximate level of obstruction 4) Change in location of the stone, if demonstrated, or of the obstruction level. The decreasing mortality, from 75% in 1925 to 13.6% in recently. This is a case of gallstone ileus in a 69-year-old female. The common symptoms was fever, vomiting, abdominal pain and abdominal distension. The stone was impacted in the ileum 30cm proximal to the ileocecal junction.