Gallstone Ileus following Endoscopic Stone Extraction

Area of Science:

• Gastroenterology
• Hepatology
• Digestive Endoscopy

Background:

• Hepatitis B-induced cirrhosis and common bile duct stones are significant clinical challenges.
• Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure for managing bile duct stones.
• Complications following ERCP, though rare, require careful consideration.

Purpose of the Study:

• To report an extremely rare case of gallstone ileus following ERCP.
• To emphasize the importance of recognizing and managing this rare complication.
• To highlight the potential for spontaneous stone evacuation.

Main Methods:

• A case study of an 85-year-old female patient with hepatitis B-related cirrhosis.
• Management of common bile duct stones using ERCP, including stent placement and stone removal.
• Diagnostic imaging (CT, ultrasonography) and endoscopic procedures (colonoscopy) for diagnosis and monitoring.

Main Results:

• Successful stone removal from the common bile duct via ERCP.
• Development of gallstone ileus with an incarcerated stone in the terminal ileum.
• Spontaneous resolution of gallstone ileus, with stone evacuation confirmed via imaging.

Conclusions:

• Gallstone ileus is an exceptionally rare complication of ERCP.
• Physicians must maintain awareness of gallstone ileus, particularly after large stone removal.
• Close patient monitoring is crucial following ERCP procedures to detect rare complications.