Successful endoscopic treatment of colonic gallstone ileus using electrohydraulic lithotripsy

World J Gastroenterol. 2010 Mar 28;16(12):1533-6. doi: 10.3748/wjg.v16.i12.1533.


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.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Catheterization
  • Equipment Design
  • Gallstones / complications
  • Gallstones / therapy*
  • Gastroscopes
  • Humans
  • Ileus / etiology
  • Ileus / therapy*
  • Lithotripsy / instrumentation
  • Lithotripsy / methods*
  • Male
  • Sigmoid Diseases / etiology
  • Sigmoid Diseases / therapy*
  • Sigmoidoscopy*
  • Tomography, X-Ray Computed
  • Treatment Outcome