Abstract
Double balloon endoscopy (DBE) is a novel technique for the diagnosis and treatment of the small bowel. We endoscopically treated a case with ileus from an impacted gallstone in the duodenum. A 70-year-old woman was referred to our hospital because of vomiting. Abdominal CT and duodenoscopy showed an impacted calcified gallstone 4cm in diameter in the second portion of the duodenum. We attempted to remove the stone endoscopically using electrohydraulic lithotripsy (EHL). Then we performed EHL with duodenoscopy; however, the gallstone, which had gotten smaller from the first session of EHL, passed into the small bowel. Therefore, we performed further EHL treatment using DBE. After two sessions of EHL using DBE, the stone could be fragmented. Abdominal CT performed 7 days after the last session of EHL therapy showed complete disappearance of the stone. We recommend that endoscopic treatment including the combination of EHL and DBE is considered before the decision for surgery is made.
