Novel Use of an Endoscopic Suturing Device to Repair a Cholecystoduodenal Fistula

Bouveret Syndrome: When a Stone Cannot Pass the Pylorus

“…3,4 A number of endoscopic and sometimes surgical techniques are used to remove the gallstones. 5 Although several cases of Bouveret syndrome have been reported in the literature, we present a rare case of complete resolution of intestinal obstruction by fragmentation of the gallstone and pushing of the stone into the jejunum.…”

“…6,7 The proximal jejunum and ileum are less common sites (20%–40%), and the colon, stomach, and duodenum are even less common (<5%). 5,8 At least 0.3%–0.5% of patients with gallstones develop ileus. 5 Morbidity and mortality are high at 15%–33%.…”

“…5,8 At least 0.3%–0.5% of patients with gallstones develop ileus. 5 Morbidity and mortality are high at 15%–33%. 9 Factors that lean toward fistula formation include, but are not limited to, large gallstones, extensive history of biliary disease, recurrent episodes of cholecystitis, female sex, age older than 60 years, peptic ulcer, and tumors.…”

“…9 Factors that lean toward fistula formation include, but are not limited to, large gallstones, extensive history of biliary disease, recurrent episodes of cholecystitis, female sex, age older than 60 years, peptic ulcer, and tumors. 5,8,10…”

“…Depending on the size of the gallstone, it can either pass into the feces or get lodged into the intestine, causing intestinal obstruction in 15% of cases. 5 Most commonly reported symptoms of intestinal obstruction in various case reports and literature reviews are abdominal pain, distention, nausea, vomiting, fever, and hematemesis in rare cases. 11…”