A Multidisciplinary Approach to Management of Bouveret Syndrome

Watson, Ryan S.; Folkers, Trey E.; Every, Marvin J. Van

doi:10.3121/cmr.2018.1430

Cited by 6 publications

(9 citation statements)

References 6 publications

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“…8 Endoscopic visualisation of the stone is possible in only about 69% of cases, owing to submucosal embedding of the stone. 9 The endoscopic findings suggestive of Bouveret syndrome are dilated stomach containing old digested food from gastrointestinal obstruction, together with a hard, non-fleshy and convex mass at the obstruction. 5 Multiple endoscopic modalities have been used for treatment of Bouveret syndrome including endoscopic stone removal with nets or baskets.…”

Section: Discussionmentioning

confidence: 99%

“…If there are no residual stones in the gallbladder with a patent cystic duct, theoretically the simple stone extraction method can lead to the fistula closing spontaneously. 6,9 The second approach of surgery is more invasive and continues to be actively debated on whether patients should have a 'one-stage procedure' that involves a gastrotomy or enterotomy and stone extraction, with or without cholecystectomy and repair of cholecystoduodenal fistula. This may require partial resection of the duodenum and common bile duct surgery with tertiary centre involvement.…”

Section: Figure 1 Endoscopic View Of Large Gallstone Obstructing the Pylorusmentioning

confidence: 99%

“…The benefits include preventing recurrent cholecystitis, cholangitis, gallstone ileus and the occurrence of fistulising gallbladder carcinoma. 6,9 Chowbey et al illustrated the success of the laparoscopic endostapling for patients with a cholecystoenteric fistula; however, the mean age of the patients was 57.2 years with no comment on comorbidities. 17 Reisner et al reviewed 1001 reported cases of gallstones ileus and concluded a one-stage procedure carried a mortality of 16.9%, compared with 11.7% for simple enterolithotomy.…”

Section: Figure 1 Endoscopic View Of Large Gallstone Obstructing the Pylorusmentioning

confidence: 99%

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A case report and review of the literature of Bouveret syndrome

Singh

Merali

Shirol

et al. 2020

annals

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Bouveret syndrome is a rare variant of gallstone ileus causing gastric outlet obstruction. It results from the formation of either a cholecystoduodenal or a cholecystogastric fistula and subsequent migration of gallstone into the duodenum or pylorus of stomach, causing obstruction. The first case was reported by Leon Bouveret in 1896. We report a case illustrating the rarity and severity of this condition, together with a review of the literature of the different methods of endoscopic and surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Figure 1 Endoscopic View Of Large Gallstone Obstructing the Pylorusmentioning

confidence: 99%

Section: Figure 1 Endoscopic View Of Large Gallstone Obstructing the Pylorusmentioning

confidence: 99%

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A case report and review of the literature of Bouveret syndrome

Singh

Merali

Shirol

et al. 2020

annals

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“…One of the complications of the cholecystoduodenal fistula was presented in our second case -Bouveret syndrome, which implies proximal duodenal or distal stomach obstruction by biliary calculus. It is a rare syndrome that affects elderly women with previous history of biliary calculosis [6,14,15].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous cholecystoduodenal fistula - spectrum of complications

et al. 2019

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Introduction Spontaneous cholecystoduodenal fistula is a rare complication of the gallbladder calculosis. Bowel obstruction is the complication in less than 1% of these patients. The pathognomonic triad (Rigler triad) of pneumobilia, small-bowel distention, and ectopic gallstones is typical for gallstone ileus. In only 1-3% of the patients with bowel obstruction by ectopic gallstone the localization of obstruction is in the duodenum, and it is called Bouveret syndrome. The rarest complication is a floating non-obstructing gallstone trapped in the stomach. Outline of cases We present three elderly female patients with persistent abdominal pain and known gallbladder calculosis in the patients' histories. Plain radiography of the thorax and abdomen and ultrasound were performed as the first choice and contrast-enhanced computer tomography (CT) was done subsequently. In the first patient, CT and magnetic resonance imaging (MRI) showed signs of pneumobilia, cholecystoduodenal fistula, and the presence of the gallstone in the stomach. The iodine contrast X-ray swallow test revealed a cholecysto-duodenal bulb fistula and floating calculus in the stomach, confirmed by endoscopy. In the second patient with persistent abdominal pain, CT and barium swallow test showed signs of pneumobilia, cholecystoduodenal fistula, and two ectopic gallstones obstructing duodenum-Bouveret syndrome. The third case showed signs of the Rigler triad-typical signs of gallstone ileus. Conclusion Spontaneous cholecystoduodenal fistula is a rare condition with possible complications such as Bouveret syndrome, gallstone ileus and floating, non-obstructive gallstones in the stomach, as the rarest possible complication. CT, MRI with magnetic resonance cholangiopancreatography, as well as the contrast X-ray swallow test can be very helpful in the detection of the bilio-enteric fistula and ectopic gallstones.

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“…Bouveret syndrome is a rare complication of cholecystitis, where impaction of a large gallstone through a cholecystoduodenal fistula into the proximal duodenum leads to gastric outlet obstruction (GOO) [ 1 ]. Gallstone ileus only makes up 1–4% of bowel obstructions and Bouveret syndrome comprises just 3% of these cases [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic lithotripsy for Bouveret syndrome complicated by small bowel obstruction secondary to gallstone fragments

Goonawardhana

Huynh

Rabindran

et al. 2021

Journal of Surgical Case Reports

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Bouveret syndrome is a rare complication of cholecystitis, in which impaction of a gallstone creates a cholecystoduodenal fistula leading to gastric outlet obstruction. We report a case of a 90-year-old female who presented with nausea and vomiting on a background of previous necrotic cholecystitis managed conservatively. Computed tomography of the abdomen demonstrated a large gallstone impacted in the third part of the duodenum leading to gastric outlet obstruction. Given her frailty, the patient underwent endoscopy to relieve the obstruction; however, complete retrieval of the gallstone fragments after lithotripsy was not possible. She subsequently developed distal gallstone ileus due to migration of the gallstone fragments and underwent laparotomy, enterotomy and retrieval of the fragments. This case highlights the dilemma of managing elderly patients with Bouveret syndrome with open or endoscopic surgery and the importance of retrieving all gallstone fragments after lithotripsy to avoid iatrogenic complications, such as gallstone ileus.

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A Multidisciplinary Approach to Management of Bouveret Syndrome

Cited by 6 publications

References 6 publications

A case report and review of the literature of Bouveret syndrome

A case report and review of the literature of Bouveret syndrome

Spontaneous cholecystoduodenal fistula - spectrum of complications

Endoscopic lithotripsy for Bouveret syndrome complicated by small bowel obstruction secondary to gallstone fragments

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