A Case of Intragastric Gallstones That Could Be Removed Endoscopically

Abstract

Background: Intragastric gallstones caused by cholecystogastric fistula are rare and may lead to gastrointestinal obstruction, the so-called Bouveret syndrome. Although surgical intervention has traditionally been the standard, endoscopic management may be feasible for selected patients. Case Presentation: A man in his 80s presented with a history of chronic abdominal pain. Contrast-enhanced computed tomography revealed a large gallstone within the stomach and a cholecystogastric fistula with no evidence of intestinal obstruction or severe inflammation. Endoscopic lithotripsy was successfully performed using a snare and a mechanical lithotripter, and complete removal was achieved without complications. Postprocedural follow-up revealed no recurrence or adverse events. Conclusion: Endoscopic lithotripsy may be a safe and effective treatment option for intragastric gallstones in carefully selected patients, particularly when the stones are accessible and no intestinal obstruction is present.