Case Report
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Mar 28, 2010; 16(12): 1533-1536
Published online Mar 28, 2010. doi: 10.3748/wjg.v16.i12.1533
Successful endoscopic treatment of colonic gallstone ileus using electrohydraulic lithotripsy
Martin D Zielinski, Lincoln E Ferreira, Todd H Baron
Martin D Zielinski, Division of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN 55901, United States
Lincoln E Ferreira, Department of Medicine, Federal University of Juiz de Fora, Juiz de Fora, 36036-330, Brazil
Todd H Baron, Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55901, United States
Author contributions: Zielinski MD wrote the manuscript; Baron TH and Ferreira LE critically edited the manuscript, developed and performed the technique used in this paper, and provided the concept of this report.
Correspondence to: Dr. Todd H Baron, Department of Gastroenterology and Hepatology, Mayo Clinic, Charlton 8A, 200 First St. SW, Rochester, MN 55901, United States.
Telephone: +1-507-2666931 Fax: +1-507-2663939
Received: November 11, 2009
Revised: December 19, 2009
Accepted: December 26, 2009
Published online: March 28, 2010

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.

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