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Successful endoscopic treatment of colonic gallstone ileus using electrohydraulic lithotripsy

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Author(s): Martin D Zielinski, Lincoln E Ferreira, Todd H Baron

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 16;
Issue: 12;
Start page: 1533;
Date: 2010;
Original page

Keywords: Gallstone ileus | Endoscopy | Electrohydraulic lithotripsy | Bowel obstruction | Colon

ABSTRACT
The surgical management of gallstone ileus is complex and potentially highly morbid. Initial management requires enterolithotomy and is generally followed by fistula resection at a later date. There have been reports of gallstone extraction using various endoscopic modalities to relieve the obstruction, however, to date, there has never been a published case of endoscopic stone extraction from the colon using electrohydraulic lithotripsy. In this report, we present the technique employed to successfully perform an electrohydraulic lithotripsy for removal of a large gallstone impacted in the sigmoid colon. A cavity was excavated in an obstructing 4.1 cm lamellated stone in the sigmoid colon using electrohydraulic lithotripsy. A screw stent retractor and stent extractor bored a larger lumen which allowed for guidewire advancement and stone fracture via serial pneumatic balloon dilatation. The stone fragments were removed. Electrohydraulic lithotripsy is a safe and effective method to treat colonic obstruction in the setting of gallstone ileus.
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