Korean J Gastroenterol.  2011 Feb;57(2):125-128. 10.4166/kjg.2011.57.2.125.

A Case of Gallstone Ileus Treated with Electrohydraulic Lithotripsy Guided by Colonoscopy

• Shin KH
• Kim DU
• Choi MG
• Kim WJ
• Ryu DY
• Lee BE
• Kim GH
• Song GA

• KMID: 1775843
• DOI: http://doi.org/10.4166/kjg.2011.57.2.125

Abstract

A 63-year-old woman was admitted to the hospital with abdominal pain and nausea. Her abdomen was distended with obstructive bowel sounds on exam. There was diffuse abdominal tenderness but no palpable masses. Abdominal computed tomography (CT) scan revealed a large gallstone in the ileum. Surgical intervention was deferred given patient's known significant liver cirrhosis (Child-Pugh class B). Instead colonoscopy was performed and a large gallstone was found to be impacted at the ileocecal valve. The gallstone was fragmented using electrohydraulic lithotripsy (EHL) and then retrieved with snare and forceps. The patient made a full recovery and was eventually discharged home. This is the first reported case of an impacted gallstone at the ileocecal valve with successful colonoscopic treatment using electrohydraulic lithotripsy in Korea. This case highlights the potential therapeutic benefits for colonscopic retrieval of a gallstone impacted at the ileocecal valve in well selected individuals.

Keyword

Gallstones; Ileus; Colonoscopy; Lithotripsy

MeSH Terms

Abdominal Pain/radiography
Colonoscopy
Female
Gallstones/*diagnosis/therapy
Humans
Ileus/*diagnosis/therapy
Intestinal Obstruction/diagnosis/therapy
Lithotripsy/*methods
Middle Aged
Tomography, X-Ray Computed

Figure

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  Fig. 1. Plain abdominal X-ray finding. X-ray showed distended bowel loops and the migration of a plastic stent.

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  Fig. 2. Computed tomography. CT scan showed a large gallstone with ERBD in the ileocecal valve.

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  Fig. 3. Colonoscopic removal of gallstone in the ileocecal valve. (A) A large gall stone was pulverized using electrohydraulic lithotripsy.(B) A large gallstone was retrieved using forceps (C) and snare.

Reference

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