Bouveret's Syndrome: Case Report and Review of the Literature

Doycheva, Iliana; Limaye, Alpna R.; Suman, Amitabh; Forsmark, Christopher E.; Sultan, Shahnaz

doi:10.1155/2009/914951

Cited by 53 publications

(86 citation statements)

References 17 publications

(26 reference statements)

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“…Other non-specific symptoms include hematemesis, weight loss, anorexia and duodenal perforation [1–14]. Differential Diagnosis include pancreatitis, perforated peptic ulcer, malignant fistula, gastric volvulus [4,5,12–14]. …”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic procedures are always attempted first with a success rate of less than 10% [5]. It can be accompanied by lithotripsy but it can cause the stone fragments to migrate distally causing gallstone ileus.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic options are tried first as majority of patients are elderly and poor surgical candidates. Gallstones that are larger than 2.5 cm are difficult to remove endoscopically, can result in esophagus impaction or distal impaction if they are broken into fragments [5]. Laparoscopic and open surgical options are then explored.…”

Section: Discussionmentioning

confidence: 99%

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Rare cause of gastric outlet obstruction

Gandhi

Jani

2018

Journal of Community Hospital Internal Medicine Perspectives

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Bouveret’s syndrome is a rare cause of gastric outlet obstruction. The stones enter the small bowel via cholecysto-enteric fistula. The most common presenting symptoms are abdominal pain, nausea and vomiting. The gold standard diagnostic test isesophagogastroduodenoscopy (EGD). Rigler’s triad on abdominal x-ray is classic. CT scan findings are pneumobilia, cholecystoduodenal fistula and a gallstone in the duodenum. We present a case of a 75-year-old female who presents with 3 week history of nausea, vomiting, and diffuse abdominal pain. Initial presentation, imaging and EGD was concerning for malignancy. She was later diagnosed to have Bouveret’s syndrome and underwent laparoscopic small bowel enterotomy with removal of gallstones

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Rare cause of gastric outlet obstruction

Gandhi

Jani

2018

Journal of Community Hospital Internal Medicine Perspectives

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“…Many authors recommend the endoscopic or percutaneous method before the surgical intervention [2,10,11], because we are dealing with elderly patients, with multiple comorbidities, which can lead to intra-and postoperative complications. Endoscopic or percutaneous treatment methods are: mechanical lithotripsy, laser lithotripsy, extracorporeal shock wave lithotripsy and intracorporeal electrohydraulic lithotripsy.…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy in Bouveret's Syndrome. A Case Report

Dénes

Török

Éltes

et al. 2016

Acta Medica Marisiensis

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Bouveret's syndrome is a high mechanical obstruction due to impaction of a gallstone into the duodenum, through a cholecystoduodenal fistula. It belongs to a larger group of gallstone ileus, a disease which occurs after developing a fistula between the gallbladder and the gastrointestinal tract. This is a rare complication of gallstones but because it appears in elderly people, it has a high morbidity and mortality. Patients have various symptoms and the treatment is individualized. We present here a case of a 67 years old patient, admitted in emergency, presenting symptoms of high bowel obstruction, with onset 5 days before admission. Abdominal ultrasound reveals a 5 cm stone that seems to be in the gallbladder, gastric stasis and at gastroscopy appears a foreign body impacted in the duodenum. After a short preparation the patient underwent surgery. We found a dilated stomach and a large cholecystoduodenal fistula with an impacted gallstone in the duodenum. We performed one stage surgery: cholecystectomy, extraction of the stone and suturing of the fistula. We reestablished the continuity of the intestinal tract. We performed also an ileostomy for feeding the patient and protecting the anastomoses. The postoperative evolution was favorable. We consider that one stage surgical treatment in gallstone ileus is an option, if the patient is in good condition and we have an adequate postoperative intensive care management.

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“…Computed tomography is the modality of choice for diagnosis. Conservative treatment is helpful in some cases, while endoscopy-guided removal of the stone and surgical correction of fistula may be required in some [2]. …”

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confidence: 99%