Duodenal Obstruction by a Gallstone (Bouveret's Syndrome) Managed by Endoscopic Stone Extraction: A Case Report and Review

Gastric outlet obstruction caused by a large gallstone in the duodenum or pylorus (Bouveret's syndrome) is a rare complication of gallstone disease. The presenting symptoms are often nonspecific and include nausea, vomiting, epigastric pain and a history of gallbladder disease. Although the diagnosis is established only at surgery in many cases, preoperative recognition by imaging techniques and endoscopy is desirable. Surgical treatment aims at removal of the ectopic gallstone, closure of the fistula and cholecystectomy. A case of Bouveret's syndrome is presented where endoscopic extraction of the duodenal gallstone was accomplished providing definitive treatment for this patient.

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Bouveret’s syndrome: A challenging case of gastric outlet obstruction.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.06.3894 ◽

2020 ◽

Vol 27 (06) ◽

pp. 1316-1319

Author(s):

Marrium Gul ◽

Irfan Qadir ◽

Muhammad Qasim Butt

Keyword(s):

Gastric Outlet Obstruction ◽

Epigastric Pain ◽

Duodenal Bulb ◽

Outlet Obstruction ◽

Postoperative Recovery ◽

Blood Analysis ◽

Bouveret’S Syndrome ◽

Endoscopic Extraction ◽

Bilioenteric Fistula ◽

Bouveret's Syndrome

Bouveret’s syndrome causes gastric outlet obstruction when a gallstone is impacted in the duodenum or stomach via a bilioenteric fistula. We present case of a 40-year-old female presented with epigastric pain and intractable vomiting for 2 days. Her physical examination and laboratory workup including blood analysis, amylase test and lipase test were normal. Plain abdominal X-ray did not show any signs of small bowel obstruction. A nasogastric tube was placed and drained 2.5 L of gastric contents immediately. Esophagogastroduodenoscopy showed a dilated stomach with excessive secretions and a large blackish-brown hard stone in the duodenal bulb. After failed attempt at endoscopic extraction, patient underwent laparotomy and removal of stone via duodenal incision. Subsequently, the patient exhibited a good postoperative recovery. The condition of the patient has remained stable after being followed up for one year.

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Bouveret’s Syndrome – Case Series with Therapeutic Implications

Zeitschrift für Gastroenterologie ◽

10.1055/a-1113-7966 ◽

2020 ◽

Vol 58 (04) ◽

pp. 352-356

Author(s):

Tobias Kukiolka ◽

Jan Borovicka ◽

Stephan Baumeler ◽

Marc Schiesser ◽

Christoph Gubler

Keyword(s):

Balloon Dilatation ◽

Rare Complication ◽

Gallstone Disease ◽

Treatment Algorithm ◽

Case Series ◽

Endoscopic Technique ◽

Bouveret’S Syndrome ◽

Therapeutic Implications ◽

Electrohydraulic Lithotripsy ◽

Bouveret's Syndrome

AbstractBouveret’s syndrome is a rare complication resulting from gallstone disease. Both surgical and endoscopical procedures are performed, with the disease to be seen as strictly interdisciplinary. There are no well-established recommendations for this condition. In this paper, we want to describe our experience from 6 cases in 3 Swiss hospitals from 2015 to 2017 with emphasis on the endoscopic technique of electrohydraulic lithotripsy followed by balloon dilatation and propose a treatment algorithm.

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

Gastroenterology Research and Practice ◽

10.1155/2009/914951 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 21

Author(s):

Iliana Doycheva ◽

Alpna Limaye ◽

Amitabh Suman ◽

Christopher E. Forsmark ◽

Shahnaz Sultan

Keyword(s):

Duodenal Bulb ◽

Outlet Obstruction ◽

Success Rates ◽

Cholecystoduodenal Fistula ◽

Bouveret’S Syndrome ◽

Endoscopic Extraction ◽

Extracorporeal Lithotripsy ◽

Endoscopic Retrieval ◽

Uncommon Condition ◽

Bouveret's Syndrome

Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula. Initial attempts at endoscopic retrieval with or without mechanical or extracorporeal lithotripsy should be performed as first-line treatment, though success rates with endoscopic treatment are variable. We describe a case of Bouveret's Syndrome in an elderly patient that was successfully treated with endoscopic extraction combined with mechanical lithotripsy, and review the literature on this uncommon condition.

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Bouveret's syndrome: a rare complication of gallstone disease

Liver International ◽

10.1111/liv.12123 ◽

2013 ◽

Vol 33 (7) ◽

pp. 1132-1132 ◽

Cited By ~ 2

Author(s):

Filippo Antonini ◽

Valerio Belfiori ◽

Giampiero Macarri

Keyword(s):

Rare Complication ◽

Gallstone Disease ◽

Bouveret’S Syndrome ◽

Bouveret's Syndrome

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Gastric Outlet Obstruction Due to Cholecysto-Gastric Fistula: Bouveret’s Syndrome

10.22514/sv.2020.16.0036 ◽

2020 ◽

Keyword(s):

Gastric Outlet Obstruction ◽

Epigastric Pain ◽

Outlet Obstruction ◽

Diagnostic Value ◽

Gastric Fistula ◽

Bouveret’S Syndrome ◽

X Ray ◽

Gastrointestinal Obstruction ◽

Biliary Enteric Fistula ◽

Bouveret's Syndrome

Bouveret’s syndrome is defined as gastrointestinal obstruction due to an impacted gallstone secondary to biliary-enteric fistula. This is often observed with nonspecific symptoms such as epigastric pain, nausea, and vomiting. The diagnosis is made by visualization of pneumobilia, gastric outlet obstruction and ectopic gallstone. In this report, we discussed an elderly patient who was admitted to the emergency department with abdominal pain and vomiting without any signs of bowel obstruction in plain x-ray and ultrasound imaging. We aimed to remind the importance of clinical suspicion and the diagnostic value of computed abdominal tomography for emergency physicians.

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