Electrohydraulic Lithotripsy of an Impacted Enterolith Causing Acute Afferent Loop Syndrome

Overview

Journal Clin Endosc

Date 2014 Aug 19

PMID 25133128

Citations 6

Authors

Young Sin Cho

Tae Hoon Lee

Soon Oh Hwang

Sunhyo Lee

Yunho Jung

Il-Kwun Chung

Sang-Heum Park

Sun-Joo Kim

Affiliations

Soon will be listed here.

Abstract

Afferent loop syndrome caused by an impacted enterolith is very rare, and endoscopic removal of the enterolith may be difficult if a stricture is present or the normal anatomy has been altered. Electrohydraulic lithotripsy is commonly used for endoscopic fragmentation of biliary and pancreatic duct stones. A 64-year-old man who had undergone subtotal gastrectomy and gastrojejunostomy presented with acute, severe abdominal pain for a duration of 2 hours. Initially, he was diagnosed with acute pancreatitis because of an elevated amylase level and pain, but was finally diagnosed with acute afferent loop syndrome when an impacted enterolith was identified by computed tomography. We successfully removed the enterolith using direct electrohydraulic lithotripsy conducted using a transparent cap-fitted endoscope without complications. We found that this procedure was therapeutically beneficial.

Citing Articles

Migrated Pancreaticojejunal Stent Forming a Stent-Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report.

Kim J, Kim Y, Lee B J Korean Soc Radiol. 2023; 84(2):512-517.

PMID: 37051393 PMC: 10083637. DOI: 10.3348/jksr.2022.0102.

Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction.

Wang S, Yang X, Zheng Y, Wu Y J Int Med Res. 2021; 49(1):300060520979377.

PMID: 33445996 PMC: 8162205. DOI: 10.1177/0300060520979377.

Intestinal stones: A rare cause of bowel obstruction.

de Leon Castorena E, de Leon Castorena M SAGE Open Med Case Rep. 2019; 7:2050313X19849837.

PMID: 31205711 PMC: 6537081. DOI: 10.1177/2050313X19849837.

Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith.

Komaki Y, Kanmura S, Tanaka A, Nakashima M, Komaki F, Iwaya H Intern Med. 2019; 58(17):2473-2478.

PMID: 31118399 PMC: 6761349. DOI: 10.2169/internalmedicine.2745-19.

Afferent loop obstruction with obstructive jaundice and ileus due to an enterolith after distal gastrectomy: A case report.

Sato K, Banshodani M, Nishihara M, Nambu J, Kawaguchi Y, Shimamoto F Int J Surg Case Rep. 2018; 50:9-12.

PMID: 30064120 PMC: 6077837. DOI: 10.1016/j.ijscr.2018.06.005.

References

Capaccio E, Zuccarino F, Gauglio C, Pretolesi F, Derchi L . Acute obstruction of the afferent loop caused by an enterolith. Emerg Radiol. 2006; 13(4):201-3. DOI: 10.1007/s10140-006-0504-x. View

Gale M, Gerzof S, Kiser L, Snider J, Stavis D, Larsen C . CT appearance of afferent loop obstruction. AJR Am J Roentgenol. 1982; 138(6):1085-8. DOI: 10.2214/ajr.138.6.1085. View

JORDAN Jr G . Surgical management of postgastrectomy problems. Arch Surg. 1971; 102(4):251-9. DOI: 10.1001/archsurg.1971.01350040013004. View

Lee T, Hwang J, Choi H, Moon J, Cho Y, Yoo B . One-Step Transpapillary Balloon Dilation under Cap-Fitted Endoscopy without a Preceding Sphincterotomy for the Removal of Bile Duct Stones in Billroth II Gastrectomy. Gut Liver. 2012; 6(1):113-7. PMC: 3286728. DOI: 10.5009/gnl.2012.6.1.113. View

Wise S . Case 24: Afferent loop syndrome. Radiology. 2000; 216(1):142-5. DOI: 10.1148/radiology.216.1.r00jl35142. View

Carbognin G, Biasiutti C, Ceratti S, Procacci C . Afferent loop syndrome presenting as enterolith after Billroth II subtotal gastrectomy: a case report. Abdom Imaging. 2000; 25(2):129-31. DOI: 10.1007/s002619910030. View

Burdick J, Garza A, Magee D, Dykes C, Jeyarajah R . Endoscopic management of afferent loop syndrome of malignant etiology. Gastrointest Endosc. 2002; 55(4):602-5. DOI: 10.1067/mge.2002.122584. View

Kim J, Park C, Huh J, Park J, Park S, Song S . Endoscopic management of afferent loop syndrome after a pylorus preserving pancreatoduodenecotomy presenting with obstructive jaundice and ascending cholangitis. Clin Endosc. 2012; 44(1):59-64. PMC: 3363051. DOI: 10.5946/ce.2011.44.1.59. View

Moriura S, Ikeda S, Kimura A, Iwatsuka Y, Ikezawa T, Naiki K . Jaundice due to afferent loop obstruction following hepatectomy for a hilar cholangiocarcinoma. Abdom Imaging. 1996; 21(3):226-7. DOI: 10.1007/s002619900051. View

10.

Lee M, Bui J, Knuttinen M, Gaba R, Helton W, Owens C . Enterolith causing afferent loop obstruction: a case report and literature review. Cardiovasc Intervent Radiol. 2009; 32(5):1091-6. DOI: 10.1007/s00270-009-9561-3. View

11.

Bourke M, Schneider D, Haber G . Electrohydraulic lithotripsy of a gallstone causing gallstone ileus. Gastrointest Endosc. 1997; 45(6):521-3. DOI: 10.1016/s0016-5107(97)70186-x. View

12.

Kim H, Moon J, Choi H, Koo H, Park S, Cheon Y . Endoscopic removal of an enterolith causing afferent loop syndrome using electrohydraulic lithotripsy. Dig Endosc. 2010; 22(3):220-2. DOI: 10.1111/j.1443-1661.2010.00981.x. View

13.

Moriura S, Takayama Y, Nagata J, Akutagawa A, Hirano A, Ishiguro S . Percutaneous bowel drainage for jaundice due to afferent loop obstruction following pancreatoduodenectomy: report of a case. Surg Today. 1999; 29(10):1098-101. DOI: 10.1007/s005950050652. View