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BACKGROUND:Colonic gallstone is an uncommon entity with high morbidity and mortality due to various reasons. It remains a diagnostic challenge because of delayed and non-speciifc presentations, especially in the elderly population, often with multiple co-morbidities. METHOD:We present a case of 81-year-old woman who had a large bowel obstruction due to colonic gallstone. RESULTS:Immediately after a cholecysto-colonic ifstula was found by laporotomy, she underwent a single stage enterolithotomy, cholecystectomy and ifstula closure. CONCLUSIONS:A single stage enterolithotomy, cholecys-tectomy and ifstula closure is ideal for this condition. Various other surgical options in the literature are discussed.