Abstract
Background: Colonic Gallstone ileus (CGI) is an uncommon mechanical bowel obstruction caused by intraluminal impaction of one or more gallstones. Gallstones enter the colon though a fistula between the gallbladder and the transverse colon wall. Case Report: We report a case of an 83-year-old lady who presented with symptoms of large bowel obstruction. The Contrast Enhanced Computed Tomography (CECT) of the abdomen showed an obstructing gallstone in the sigmoid colon and extensive diverticulosis. At colonoscopy, a large gallstone was seen impacted in the sigmoid colon. Endoscopic laser lithotripsy under general anesthesia was successful in relieving the obstruction. This procedure avoided the unfit patient a major surgery. Conclusion: Colonic gallstone ileus is a rare type of large bowel obstruction caused by gallstone impaction in patients with cholecysto-colonic fistula. We describe a case of CGI successfully treated with endoscopic laser lithotripsy. This therapeutic endoscopic approach of impacted colonic gallstone is effective and can be attempted in order to avoid surgery, especially in elderly patients, who are unfit for surgery.
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