A rare presentation of gastric outlet obstruction (GOO) - The Bouveret's syndrome

Abstract

IntroductionBouveret's Syndrome is a rare cause of Gastric outlet obstruction (GOO) caused by a gall stone which has migrated into the duodenal bulb from a bilioduodenal fistula. It is an uncommon condition and only a few cases have been reported in the medical literature till to date.Presentation of caseWe report a case of a 45 year old woman who presented to us with recurrent pain in the upper abdomen for the last 8 years, and that progressed to develop symptoms of gastric outlet obstruction. An upper gastrointestinal endoscopy revealed duodenal ulceration with a stony hard lesion in the first part of duodenum. An contrast enhanced computed tomography (CECT) scan of the abdomen performed later confirmed the presence of cholecystoduodenal fistula and a gall-stone in proximal jejunum.DiscussionBouveret's syndrome is a case of gastric outlet obstruction caused by the impaction of a large gall stone in the duodenum as a result of a cholecystoduodenal fistula. It constitutes 1–3% of cases of gall stone ileus which in turn complicates only 0.3–4% cases of cholelithisasis. Bouveret's syndrome is managed surgically.ConclusionBouveret's syndrome being an uncommon condition may pose a difficulty in diagnosis and dilemma in managing such patients. An awareness is hence essential.

Uncommon presentation of a common disease - Bouveret's syndrome: A case report and systematic literature review

“…The fistula can be cholecystogastric (less common) or more commonly, cholecystoduodenal. BS constitutes 1%-3% of cases of gall stone ileus which in turn complicates only 0.3%-4% cases of cholelithisasis [91,107] . BS can be associated with high mortality (up to 12%) mainly due to the frailty of patients [136] .…”

Bouveret Syndrome: A Rare Case of Instance and Treatment in a Younger Patient

“…Our recommendations fall in line with the successful treatment of Bouveret syndrome in patients below the age of 50. ose cases documenting a cholecystectomy performed this procedure within the same operation as the removal of Case Reports in Gastrointestinal Medicine the gallstone, with successful results [10][11][12][13]. Furthermore, all cases of patients below the age of 50 carried out a fistula repair, again with successful results [10][11][12][13][14]. As such, our case, alongside the existing literature regarding treatment in younger patients, shows that younger patients indeed can accept the greater surgical pressures associated with these approaches.…”

Rare Cause of Gastric Outlet Obstruction

“…The most common presenting symptoms are abdominal pain, nausea and vomiting. Other non-specific symptoms include hematemesis, weight loss, anorexia and duodenal perforation [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Differential Diagnosis include pancreatitis, perforated peptic ulcer, malignant fistula, gastric volvulus [4,5,[12][13][14].…”