Gallstones can work their way through different tissue layers by means of chronic irritation and the formation of abscesses. Here we present the case of a 74-year-old man who, after having attacks of pain in the upper abdominal region for years, was admitted with signs of peritoneal irritation and haemodynamic shock. An emergency laparotomy revealed old blood, pus and a large hole in the frontal part of the liver. A loose gallstone was found in the cavity. Each step this gallstone had taken from the gallbladder to the peritoneal cavity could, with hindsight, be traced back to the clinical course of the disease. Liver abscesses and rupture are rare complications of cholelithiasis.