Bouveret syndrome: Primary demonstration of cholecystoduodenal fistula on MR and MRCP study

Negi, R. S.; Chandra, Mukul; Kapur, Rajiv

doi:10.4103/0971-3026.150136

Cited by 17 publications

(10 citation statements)

References 12 publications

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“…Cholecystoenteric fistulas include cholecystogastric, cholecystoduodenal, and cholecystocolonic fistulas with the cholecystoduodenal type being the most common [1] . The symptoms and signs of these fistulas may range from nonspecific to life-threatening [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] . They are usually related to chronic cholecystitis or long-standing cholelithiasis.…”

Section: Introductionmentioning

confidence: 99%

“…The computed tomography (CT) manifestations of a bilioenteric fistula include pneumobilia, 2 approximated organs with an edematous wall, pericholecystic inflammatory change, a gall stone in the gastrointestinal tract, bowel dilatation, and direct visualization of the fistula [1] , [2] , [3] , [4] , [5] , [6] . A primary demonstration of cholecystoduodenal fistula has been reported [7] , [8] , [9] , [10] . In the following account, a patient without prior symptoms or signs of cholelithiasis was shown by CT to have a fistulous tract communicating the gall bladder and gastric antrum.…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography demonstration of cholecystogastric fistula

Chou

2016

Radiology Case Reports

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Cholecystogastric fistula is a rare complication of chronic cholecystitis or long-standing cholelithiasis. It results from the gradual erosion of the approximated, chronically inflamed wall of the gall bladder and stomach with fistulous tract formation. The present case describes the direct visualization of a cholecystogastric fistula by computed tomography in a patient without prior biliary system complaints.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Computed tomography demonstration of cholecystogastric fistula

Chou

2016

Radiology Case Reports

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“…MRI with MRCP is useful in detecting isoattenuating gallstones and in patients with the intolerance to oral contrast medium. Negi et al [19] successfully demonstrated that gallstones, pneumobilia, as well as cholecystoduodenal fistula, can be visualized by this imaging modality.…”

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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“…In cases where a gallstone is isoattenuating relative to bile or fluid, and oral contrast material cannot be tolerated (as in our case), MRCP or other T 2 weight MR sequences may serve as a useful adjunct for confirming the diagnosis of gallstone ileus or better delineating fistula anatomy. 3 , 20 , 25 On MRCP ectopic calculi will appear as signal voids, allowing them to be easily differentiated from surrounding hyperintense fluid within the gastrointestinal tract. Further, MRCP may depict small amounts of fluid within a collapsed fistulous tract that may be otherwise difficult or impossible to appreciate on CT alone.…”

Section: Discussionmentioning

confidence: 99%

Bouveret’s syndrome—a rare form of gallstone ileus causing death: appearance on post-mortem CT and MRI

Bruni

Pickup

Thorpe³

2017

BJR|case reports

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Bouveret’s syndrome is a very rare cause of gastric outlet obstruction occurring as a complication of cholelithiasis with cholecystogastric or cholecystoenteric fistula. Without timely diagnosis and intervention Bouveret’s syndrome can be associated with a high rate of morbidity and mortality, with common causes of death including metabolic derangements, aspiration pneumonia and post-operative complications. We report the case of a 67-year-old female found dead in her home with regurgitated gastric contents filling her mouth and nasal cavity. Post-mortem CT and MRI imaging was performed and subsequently revealed a fistulous tract between the gallbladder and proximal duodenum, with impaction of a large obstructing stone in the mid-portion of the duodenum. Post-mortem imaging also revealed findings of gastric outlet obstruction, which was presumed to be a primary contributor to her cause of death.

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Bouveret syndrome: Primary demonstration of cholecystoduodenal fistula on MR and MRCP study

Cited by 17 publications

References 12 publications

Computed tomography demonstration of cholecystogastric fistula

Computed tomography demonstration of cholecystogastric fistula

Spontaneous cholecystoduodenal fistula - spectrum of complications

Bouveret’s syndrome—a rare form of gallstone ileus causing death: appearance on post-mortem CT and MRI

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