Korean J Gastroenterol.  2022 May;79(5):228-230. 10.4166/kjg.2022.057.

Large Enterolith in Afferent Loop

• Choe JW
• Hyun JJ

• KMID: 2530331
• DOI: http://doi.org/10.4166/kjg.2022.057

Figure

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  Fig. 1 Computed tomography scan of the abdomen. (A) An approximately 3.8 cm-sized large lamellated stone was seen within the afferent loop (arrow). (B) Common bile duct and pancreatic duct were both dilated, likely due to extrinsic compression of the ampulla of Vater by a huge enterolith (arrow).

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  Fig. 2 Endoscopic procedure for removing the enterolith. (A) The patient had previously undergone subtotal gastrectomy with a Braun’s anastomosis. (B) A large enterolith was occupying the lumen of the distal afferent loop. (C) Capturing the enterolith was not feasible, even with the largest mechanical lithotripsy basket. (D) Thus, the enterolith was gnawed layer by layer with rat-tooth forceps. (E) After several sessions, the enterolith became small enough to be finally captured using a mechanical lithotripsy basket and was crushed into multiple fragments. (F) The lumen could be cleared of the stone, and a compressive ulcer was noted at the margin of a large periampullary diverticulum.

Reference

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