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Gallstone ileus and bowel perforation after endoscopic sphincterotomy
M Despland1, P A Clavien, G Mentha
1Department of Digestive Surgery, University Hospital, Geneva, Switzerland.
The American Journal of Gastroenterology
|July 1, 1992
Summary
Gallstone ileus is a rare complication of endoscopic sphincterotomy (ES). Close monitoring after ES for large stones is crucial to prevent severe complications like bowel obstruction and perforation.
Area of Science:
- Gastroenterology
- Surgical Complications
Background:
- Endoscopic sphincterotomy (ES) is a procedure to treat bile duct stones.
- Gallstone ileus, a rare complication, occurs when a gallstone obstructs the bowel.
Observation:
- This report details the second known case of gallstone ileus following ES.
- The patient presented with bowel obstruction and perforation without prior instrumentation.
- The patient survived the severe complication.
Findings:
- Performing ES for large common bile duct stones carries significant risks.
- Inadequate monitoring after failed stone extraction via ES is critical.
- This failure can lead to severe gallstone ileus.
Implications:
- Emphasizes the need for vigilant monitoring post-ES for large stones.
- Highlights potential dangers of ES for large common bile duct stones.
- Suggests improved protocols for managing patients undergoing ES for large stones.