title: Large bowel obstruction due to gallstones: an endoscopic problem?
abstract: A 73-year-old man was admitted with symptoms of large bowel obstruction. An emergency CT scan revealed pneumobilia and large bowel obstruction at the level of the rectosigmoid due to a 4×4 cm impacted gallstone. Flexible sigmoidoscopy confirmed the diagnosis but initial attempts to drag the stone into the rectum failed. An endoscopic mechanical lithotripter was employed to repeatedly fracture the gallstone into smaller fragments, which were passed spontaneously the next day. The patient made a complete recovery avoiding the potential dangers of surgery. This case report discusses cholecystoenteric fistula and a novel minimally invasive treatment for large bowel obstruction due to gallstones.
authors.affiliation: Department of General Surgery, Queens Hospital-Burton, Burton-upon-Trent, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Waterland
authors.forename: Faisal Shehzaad
authors.initials: FS
authors.lastname: Khan
authors.forename: Damien
authors.initials: D
authors.lastname: Durkin
mesh_terms: D000368:Aged; D001658:Biliary Fistula / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005705:Gallbladder Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D042882:Gallstones / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000628:therapy*; D008096:Lithotripsy; D008297:Male; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000628:therapy*; D012812:Sigmoidoscopy; D014057:Tomography, X-Ray Computed