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

Kyung Hwa Shin; Dong Uk Kim; Moon Gi Choi; Won Jin Kim; Dong Yup Ryu; Bong Eun Lee; Gwang Ha Kim; Geun Am Song

doi:10.4166/kjg.2011.57.2.125

Journal List > Korean J Gastroenterol > v.57(2) > 1006772

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin, Kim, Choi, Kim, Ryu, Lee, Kim, and Song: A Case of Gallstone Ileus Treated with Electrohydraulic Lithotripsy Guided by Colonoscopy

Case Report

Korean J Gastroenterol 2011;57(2):125-128.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.2.125

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

Kyung Hwa Shin, Dong Uk Kim, Moon Gi Choi, Won Jin Kim, Dong Yup Ryu, Bong Eun Lee, Gwang Ha Kim, Geun Am Song

Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Korea

Correspondence to: Dong Uk Kim, Department of Internal Medicine, School of Medicine, Pusan National University, 1-10, Ami-dong, Seo-gu Busan 602-739, Korea. Tel: +82-51-240-7869, Fax: +82-51-244-8180, E-mail: amlm3@hanmail.net

Received 15 April 2010 Revised 2 August 2010 Accepted 3 August 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Gallstones, Ileus, Colonoscopy, Lithotripsy

References

1. VanLandingham SB, Broders CW. Gallstone ileus. Surg Clin North Am. 1982; 62:241–247.

2. Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994; 60:441–446.

3. Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Br J Surg. 1990; 77:737–742.

4. Deitz DM, Standage BA, Pinson CW, McConnell DB, Krippaehne WW. Improving the outcome in gallstone ileus. Am J Surg. 1986; 151:572–576.

5. Illuminati G, Bartolucci R, Leo G, Bandini A Jr. Gallstone ileus: report of 23 cases with emphasis on factors affecting survival. Ital J Surg Sci. 1987; 17:319–325.

6. Masannat Y, Masannat Y, Shatnawei A. Gallstone ileus: a review. Mt Sinai J Med. 2006; 73:1132–1134.

7. Abou-Saif A, Al-Kawas FH. Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol. 2002; 97:249–254.

8. Lobo DN, Jobling JC, Balfour TW. Gallstone ileus: diagnostic pitfalls and therapeutic successes. J Clin Gastroenterol. 2000; 30:72–76.

9. Yoon SM, Kim MH, Jang HJ, et al. Impacted gallstone in the ileum with a spontaneous passage. Korean J Med. 2006; 70(Suppl 2):S184–S189.

10. Murray EL, Collie M, Hamer−Hodges DW. Colonoscopic treatment of gallstone ileus. Endoscopy. 2006; 38:197.

11. Lim SY, Seong H, Park JY, Seo CH, Jang KJ, Cho SR. Imaging findings of intragastric gallstone and Bouveret's syndrome: case report. J Korean Radiol Soc. 2000; 42:133–136.

12. Seitz U, Bapaye A, Bohnacker S, Navarrete C, Maydeo A, Soehendra N. Advances in therapeutic endoscopic treatment of common bile duct stones. World J Surg. 1998; 22:1133–1144.

Fig. 1.

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

Fig. 2.

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

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.

TOOLS

Similar articles