CASE COMMUNICATIONS
IMAJ | volume 28
Journal 10, October 2026
pages: 663-665
Endoscopic Management of Gallstone Ileus with Laser and Mechanical Lithotripsy
1 Department of Surgery B, Kaplan Medical Center, Rehovot, Israel
2 Department of Urology, Kaplan Medical Center, Rehovot, Israel
3 Department of Gastroenterology and Liver Diseases, Kaplan Medical Center, Rehovot, Israel
4 Department of Thoracic and Esophageal Surgery, Kaplan Medical Center, Rehovot, Israel
5 Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
Summary
Gallstone ileus is an uncommon complication of cholelithiasis. It accounts for less than 1–4% of all small bowel obstructions [1]. The condition involves the passage of a gallstone into the gastrointestinal tract through a biliary-enteric fistula, often resulting in obstruction at the ileum or, less commonly, the duodenum. This condition is known as Bouveret syndrome [1]. Management can be surgical (gastrotomy, intragastric laparoscopy, pyloromyotomy, duodenotomy, enterotomy) or endoscopic (removal with nets/baskets, electrohydraulic lithotripsy [EHL], extracorporeal shockwave lithotripsy [ESWL]). Endoscopic management is preferred due to its lower morbidity and mortality rates [2,3].