Clin Endosc.  2014 Jul;47(4):367-370. 10.5946/ce.2014.47.4.367.

Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome

Affiliations
  • 1Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. thlee9@schmc.ac.kr

Abstract

Afferent loop syndrome caused by an impacted enterolith is very rare, and endoscopic removal of the enterolith may be difficult if a stricture is present or the normal anatomy has been altered. Electrohydraulic lithotripsy is commonly used for endoscopic fragmentation of biliary and pancreatic duct stones. A 64-year-old man who had undergone subtotal gastrectomy and gastrojejunostomy presented with acute, severe abdominal pain for a duration of 2 hours. Initially, he was diagnosed with acute pancreatitis because of an elevated amylase level and pain, but was finally diagnosed with acute afferent loop syndrome when an impacted enterolith was identified by computed tomography. We successfully removed the enterolith using direct electrohydraulic lithotripsy conducted using a transparent cap-fitted endoscope without complications. We found that this procedure was therapeutically beneficial.

Keyword

Afferent loop syndrome; Enterolith; Electrohydraulic lithotripsy

MeSH Terms

Abdominal Pain
Afferent Loop Syndrome*
Amylases
Constriction, Pathologic
Endoscopes
Gastrectomy
Gastric Bypass
Humans
Lithotripsy*
Middle Aged
Pancreatic Ducts
Pancreatitis
Amylases
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