Gastric outlet obstruction due to gall stones (Bouveret syndrome)

Abstract

Gastric outlet obstruction by gall stone is a rare complication of a common disorder. Two cases are reported here. The investigations are conducted along the same lines as for pyloric stenosis. The diagnosis can be made with a barium meal or gastroscopy. Treatment is by surgical intervention after adequate resuscitation.

Unusual presentation of Bouveret's syndrome

“…Vomiting can be either gastric, in patients with complete gastric outlet obstruction, or bile-stained, in patients with incomplete obstruction. [2][3][4] In the acute presentation, jaundice and hematemesis (caused by erosion of the cystic artery) have also been reported. 5,6 In some patients, presentation may be more chronic, and may be associated with weight loss and anorexia.…”

“…Differential diagnosis includes gastric outlet obstruction caused by neoplastic lesions, fibrotic ulcers, duodenal diverticula, and foreign bodies. [2][3][4] Our patient had no previous history of symptomatic gallstones, but had had previous gastric and duodenal ulcers. Thus, the initial diagnosis was that of recurrent ulcer causing gastric outlet obstruction.…”

Bouveret’s Syndrome Complicated by Acute Pancreatitis

“…In most circumstances the treatment of Bouveret’s syndrome is surgical. Endoscopic extraction of the obstructing stone has been described in selected patients in whom it is technically possible to dislodge and engage the stone in a Dormia basket [12, 13, 18, 22, 23]. However, the site, size and impaction of the stone in the duodenum usually does not allow endoscopic removal.…”

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

“…BS has been reported many times as a single case report. A few reports included more than one case [99,130,153,160,163,173,188] . These patients usually present with abdominal pain and vomiting as universally reported.…”