Bouveret’s Syndrome Complicated by Acute Pancreatitis

R, Fenchel; Bornman, P. C.

doi:10.1159/000018782

Cited by 10 publications

(3 citation statements)

References 14 publications

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“…Acute pancreatitis is very rare with BS [9]. Only five cases have so far been reported [9,[14][15][16][17]. Pressure from the impacted stone on the ampulla probably causes obstructive pancreatitis [16], as seen in our patient too.…”

Section: Discussionsupporting

confidence: 52%

“…Acute pancreatitis increases the difficulty in MIS due to added inflammation, makes duodenal closure difficult, and probably decreases the possibility of cholecystectomy [9,16]. In previously reported five cases of BS with acute pancreatitis, only one patient underwent laparoscopic enterolithotomy, fistula repair, and cholecystectomy and four patients had an open surgery; of the latter four, two patients had enterolithotomy and fistula repair with cholecystectomy while remaining two patients had only enterolithotomy but no cholecystectomy [9,[14][15][16][17]. There isn't much evidence on multiple fistulae and the role of MIS (again due to its rarity).…”

Section: Discussionmentioning

confidence: 99%

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Multiple Cholecystoenteric Fistulae With Bouveret Syndrome and Acute Pancreatitis: A Rare Combination

Kulkarni¹,

Goradia²,

Kulkarni³

et al. 2023

Cureus

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Multiple cholecystoenteric fistulae, Bouveret syndrome (a form of gallstone ileus), and acute pancreatitis occurring together is very rare. Diagnosis is seldom clinical and is mostly based on computerised tomography (CT) or magnetic resonance imaging (MRI). Endoscopy and minimally invasive surgery have revolutionised the treatment of Bouveret syndrome and cholecystoenteric fistula, respectively, over the last two decades. Laparoscopic repair of cholecystoenteric fistula followed by cholecystectomy is successful on a consistent basis with skilled laparoscopic suturing and advanced laparoscopy. In patients with Bouveret syndrome, when the stone is <4cm and is in the proximal duodenum, it is usually amenable for endoscopic extraction with snares, nets, forceps and lithotripsy. When endoscopy is unavailable or fails, laparoscopic surgery is suitable for these patients. However, stones >4 cm, located in the distal duodenum, multiple fistulae, and associated acute pancreatitis may necessitate open surgery. We present here a case of a 65year-old Indian female with multiple cholecystoenteric fistulae and Bouveret syndrome with acute pancreatitis with a 6.5 cm gallstone diagnosed on CT scan and MRI and treated successfully by open surgery. We also review the current literature on the management of this complex problem.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Multiple Cholecystoenteric Fistulae With Bouveret Syndrome and Acute Pancreatitis: A Rare Combination

Kulkarni¹,

Goradia²,

Kulkarni³

et al. 2023

Cureus

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show abstract

“…A stone retrieved from the duodenum after laparotomy [64] . There have been a few cases in the literature where BS presented with pancreatitis [33,122] . The stone(s) can be lodged tightly in the duodenum causing necrosis and intra or extraperitoneal perforation [109] .…”

Section: Bs Is a Rare Cause Of Gastric Outlet Obstruction Causedmentioning

confidence: 99%