Korean J Gastrointest Endosc.  2004 Oct;29(4):228-231.

A Case of Gallstone Ileus Following Endoscopic Sphincterotomy

• Kim BC
• Kim HM
• Moon CM
• Suh JH
• Cho YS
• Lee CG
• Won SY
• Park IS
• Yun SH

Abstract

Gallstone ileus is caused by mechanical obstruction of the gastrointestinal tract by the gallstone and accounts for 1~3% of all intestinal obstructions. Endoscopic sphincterotomy (EST) is the accepted treatment of choice for choledocholithiasis. Recognized complications of EST include bleeding, acute pancreatitis, retroperitoneal perforation. However, gallstone ileus is a rare complication of EST. A 70-year-old woman was admitted to our hospital with right upper quadrant pain. Abdominal ultrasound revealed single common bile duct (CBD) stone. ERCP was performed to remove the large CBD stone without mechanical lithotripsy. Nausea, vomiting and abdominal pain were developed after stone removal. Plain abdomen X-ray and computerized tomography represented marked dilatation of small bowel loops without definite obstructive lesion. Because the mechanical obstruction was sustained, explorolaparotomy was performed. On the operation, single stone was impacted at the distal ileum, narrowed by previous radiotheraphy. We reported a case of gallstone ileus after the removal of CBD stone following EST without lithotripsy.

Keyword

Gallstone ileus; Endoscopic sphincterotomy (EST); CBD stone

MeSH Terms

Abdomen
Abdominal Pain
Aged
Cholangiopancreatography, Endoscopic Retrograde
Choledocholithiasis
Common Bile Duct
Dilatation
Female
Gallstones*
Gastrointestinal Tract
Hemorrhage
Humans
Ileum
Ileus*
Intestinal Obstruction
Lithotripsy
Nausea
Pancreatitis
Sphincterotomy, Endoscopic*
Ultrasonography
Vomiting