Electrohydraulic lithotripsy of a gallstone causing gallstone ileus

Colonic gallstone ileus: the rolling stones

“…It is technically difficult as there is little difference between the size of the stone and the lumen within which it is impacted, rendering it virtually impossible to pass the scope beyond the stone or successfully deploy a basket 14 15. Finding a basket large enough to carry the stone is yet another obstacle 16. In our case, two separate attempts at colonoscopy by two different endoscopists failed to extract the stone.…”

“…The combination of endoscopy with lithotripsy has been successful in several cases. Bourke et al 16 successfully fragmented a 2.8 cm stone in 130 min using electrohydraulic lithotripsy and recommend its use in elderly patients who, due to concomitant disease, may be unfit for general anaesthetic. Given the size of the stone and duration of therapy documented here, this treatment modality was not pursued in our case.…”

Gallstone ileus successfully treated with endoscopic fragmentation by using double-balloon endoscopy (with video)

“…However, several trials, such as those using extracorporeal and electrohydraulic lithotripsy, have not been always satisfactory because of their inherent limitations, including abdominal gas, which prevented clear visualization of the obstruction on US. 7 In this case, we succeeded in the nonsurgical removal of the gallstone by using DBE. In contrast to conventional enteroscopies, DBE can be inserted deep into the small bowel, this making both a high diagnostic yield and therapeutic intervention possible in patients with suspected small-bowel diseases.…”

Large bowel obstruction due to impaction of a gallstone

“…In an effort to circumvent surgery, less invasive techniques involving colonoscopy to access the gallstone and relieve the obstruction by fragmentation using lithotripsy, have been successfully employed 7 8. However, these measures are limited by local expertise as well as the size and composition of the impacted gallstone.…”