Tummers S, Dijkman R, Belgers E, van der Heij B, Sosef M.
Zuyderland Medisch Centrum, afd. Urologie, Sittard-Geleen/Heerlen.

Abstract

BACKGROUND: A gallstone ileus is a complication of cholelithiasis that is difficult to recognise. Morbidity and mortality are both high. Treatment often consists of surgical removal of the stone. There is limited literature available about less invasive therapies such as extracorporeal shock-wave lithotripsy (ESWL).
CASE DESCRIPTION: A 72-year-old man with severe abdominal pain reported to the accident and emergency department. A blockage at the level of the sigmoid colon was visible on the CT scan, with concurrent diverticular stenosis. During a multidisciplinary consultation we decided upon treatment with ESWL. The treatment was successful, and the patient left the hospital in a good condition.
CONCLUSION: The most common surgical operation for a gallstone ileus is extraction through an enterotomy. The minimally invasive ESWL technique, however, seems to be a good alternative. To date, there have only been case study reports of this in the literature.

Ned Tijdschr Geneeskd. 2018 Dec 5;163. pii: D2860. [Article in Dutch]