Moriai T, Hasegawa T, Fuzita M, Kimura A, Tani T, Makino I
Second Department of Internal Medicine, Asahikawa Medical College, Japan.
Am J Gastroenterol. 1991 May;86(5):627-9.
We describe a case of massive gallstones discharged into the stomach through a cholecystoduodenal fistula and the successful removal of these stones by endoscopic electrohydraulic lithotripsy (EEHL) and endoscopic mechanical lithotripsy (EML) for the prevention of gallstone ileus. A 60-yr-old woman was admitted with epigastric pain and nausea. Upper gastrointestinal tract examination demonstrated backflow of contrast medium from the duodenal bulb into the gallbladder. Endoscopic examination revealed a large fistula on the anterior wall of the duodenal bulb, and two brown stones (about 3 cm in diameter) were found in the stomach. To prevent gallstone ileus, removal of these stones was attempted. They were broken into pieces by EEHL, then crushed into smaller pieces by EML and removed orally. Chemical analysis showed the composition of the gallstones to be at least 98% cholesterol. The patient was discharged one month after removal of the gallstones and has remained asymptomatic.
我们描述了一例通过胆囊十二指肠瘘排入胃内的巨大胆结石病例，并通过内镜下电液压碎石术（EEHL）和内镜机械碎石术（EML）成功取出这些结石，以预防胆石性肠梗阻。一名60岁女性因上腹部疼痛和恶心入院。上消化道检查显示造影剂从十二指肠球部反流至胆囊。内镜检查发现十二指肠球部前壁有一个大瘘口，胃内发现两颗褐色结石（直径约3厘米）。为预防胆石性肠梗阻，尝试取出这些结石。先用EEHL将结石破碎成小块，然后用EML将其粉碎成更小的碎片并经口取出。化学分析显示胆结石的成分至少98%为胆固醇。患者在结石取出后一个月出院，至今仍无症状。
