[Extracorporeal shock wave lithotripsy of an impacted gallstone in cholecysto-antral fistula].

The endoscopic examination of a patient with gastrointestinal bleeding unexpectedly revealed a cholecysto-antral fistula with incipient penetration of a gallstone into the stomach (and presumably intermittent bleeding from the fistula rim). As endoscopic extraction was not possible and the stone impacted in the fistula was visible in the ultrasound scan extracorporeal shock-wave lithotripsy was carried out. An electrohydraulic lithotripter was used and 1,913 shock waves were applied at a maximum of 26,000 volts. In a single treatment session the stone was disintegrated completely into fragments small enough for spontaneous elimination. No sedative or analgesic medication was required. There was no evidence of any complications or side-effects following the ESWL.