Korean J Gastrointest Endosc > Volume 29(4); 2004 > Article
Korean Journal of Gastrointestinal Endoscopy 2004;29(4): 228-231.
내시경적 유두괄약근 절개술 후 발생한 담석성 장폐쇄 1예
김병창·김희만·문창모·서정훈*·조용석*·이천균*·원선영*·박인서*·윤성현
연세대학교 의과대학 내과학교실, *국민건강보험공단 일산병원 내과, 일반외과
A Case of Gallstone Ileus Following Endoscopic Sphincterotomy
Byung Chang Kim, M.D., Hee Man Kim, M.D., Chang Mo Moon, M.D., Jeong Hun Suh, M.D.*, Yong Seok Cho, M.D.*, Chun Gyun Lee, M.D.*, Sun Young Won, M.D.*, In Suh Park, M.D.* and Seong Hyeun Yun, M.D.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea,*Departments of Internal Medicine and General Surgery,National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea
Abstract
Gallstone ileus is caused by mechanical obstruction of the gastrointestinal tract by the gallstone and accounts for 1∼3% of all intestinal obstructions. Endoscopic sphincterotomy (EST) is the accepted treatment of choice for choledocholithiasis. Recognized complications of EST include bleeding, acute pancreatitis, retroperitoneal perforation. However, gallstone ileus is a rare complication of EST. A 70-year-old woman was admitted to our hospital with right upper quadrant pain. Abdominal ultrasound revealed single common bile duct (CBD) stone. ERCP was performed to remove the large CBD stone without mechanical lithotripsy. Nausea, vomiting and abdominal pain were developed after stone removal. Plain abdomen X-ray and computerized tomography represented marked dilatation of small bowel loops without definite obstructive lesion. Because the mechanical obstruction was sustained, explorolaparotomy was performed. On the operation, single stone was impacted at the distal ileum, narrowed by previous radiotheraphy. We reported a case of gallstone ileus after the removal of CBD stone following EST without lithotripsy. (Korean J Gastrointest Endosc 2004;29:228⁣231)
Key Words: Gallstone ileus, Endoscopic sphincterotomy (EST), CBD stone
주요어: 담석성 장폐쇄, 내시경적 유두괄약근 절개술(EST), 담관 담석
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