Bouveret Syndrome: A Rare Form of Gallstone Ileus

Introducción. El síndrome de Bouveret es una entidad poco frecuente de íleo biliar que provoca obstrucción gástrica debido a la presencia de un lito biliar a nivel de píloro o duodeno y secundaria a una fistula biliodigestiva. Esta enfermedad es de difícil diagnóstico y una de sus complicaciones es la hemorragia digestiva alta; su manejo es quirúrgico y se recomienda en dos tiempos, aunque se puede manejar por endoscopia alta en aquellos cálculos <2.5cm. El pronóstico es bueno, con un post-operatorio sin novedades.Presentación del caso. Paciente de 63 años con cuadro clínico de 15 días de evolución de dolor en epigástrico y vómitos biliosos incontables. Se realizaron imágenes diagnósticas donde se evidenció masa calcificada en duodeno II, por lo que la paciente fue intervenida quirúrgicamente: se progresó el cálculo a yeyuno, se realizó enterotomía y se extrajo el lito. Al quinto día fue dada de alta sin novedades.Conclusión. El síndrome de Bouveret es una entidad rara que requiere de una adecuada valoración médica y de métodos auxiliares de imágenes para un diagnóstico oportuno.

Endoscopic Diagnosis of Bouveret Syndrome

Case Reports in Gastroenterology ◽

10.1159/000510162 ◽

2020 ◽

Vol 14 (3) ◽

pp. 683-686

Author(s):

Felix Hesse ◽

Mohamed Abdelhafez ◽

Christoph Schlag ◽

Roland M. Schmid ◽

Tobias Lahmer

Keyword(s):

Computed Tomography ◽

Female Patient ◽

Rare Complication ◽

Gallstone Ileus ◽

Duodenal Bulb ◽

Outlet Obstruction ◽

Endoscopic Diagnosis ◽

Endoscopic Imaging ◽

Bouveret syndrome is a form of gallstone ileus and a rare complication of chole(cysto)lithiasis. It describes gastric outlet obstruction secondary to an impacted gallstone. Here, we report a case of an 82-year-old female patient with gastric outlet obstruction and penetration of gallstones into the duodenal bulb on endoscopic imaging. Based on these findings Bouveret syndrome was diagnosed and confirmed by computed tomography.

Bouveret Syndrome or Gallstone Ileus

The American Journal of Medicine ◽

10.1016/j.amjmed.2017.10.044 ◽

2018 ◽

Vol 131 (4) ◽

pp. e175 ◽

Cited By ~ 1

Author(s):

Ervin Alibegovic ◽

Admir Kurtcehajic ◽

Ahmed Hujdurovic ◽

Svjetlana Mujagic ◽

Jasminka Alibegovic ◽

...

Keyword(s):

Gallstone Ileus ◽

Bouveret syndrome: a rare form of gallstone ileus

BMJ Case Reports ◽

10.1136/bcr-2020-238126 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238126

Author(s):

Don Haering ◽

Mattie Murphy ◽

John Craig ◽

Gavin A Falk

Keyword(s):

Clinical Evidence ◽

Incidental Finding ◽

Gallstone Ileus ◽

Definitive Treatment ◽

Abdominal Radiograph ◽

Quadrant Pain ◽

Abdominal Ct Scan ◽

History Of ◽

Bouveret Syndrome ◽

High Index Of Suspicion

A 57-year-old woman presented with a 5-day history of worsening right upper quadrant pain, bilious emesis and approximately 20 pounds of weight loss. The patient was afebrile, without jaundice and had mild tenderness in her right upper quadrant. She noted an incidental finding of asymptomatic cholelithiasis on imaging 4 years earlier. An abdominal radiograph revealed pneumobilia and a large ectopic calculus. An abdominal CT scan confirmed pneumobilia, a large concretion completely obstructing the third portion of the duodenum and a soft tissue communication between the gallbladder and proximal duodenum. She was brought to the operating room for definitive treatment and had the obstructing gallstone removed via a transverse duodenotomy. Bouveret syndrome is a rare cause of small bowel obstruction that requires a high index of suspicion for diagnosis. It should be considered in older patients with clinical evidence of gastric or duodenal obstruction, particularly with a history of cholelithiasis.

A case report and review of the literature of Bouveret syndrome

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0161 ◽

2020 ◽

Vol 102 (1) ◽

pp. e15-e19 ◽

Cited By ~ 4

Author(s):

G Singh ◽

N Merali ◽

S Shirol ◽

P Drymousis ◽

S Singh ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Rare Variant ◽

Gallstone Ileus ◽

Outlet Obstruction ◽

Review Of The Literature ◽

First Case ◽

Bouveret syndrome is a rare variant of gallstone ileus causing gastric outlet obstruction. It results from the formation of either a cholecystoduodenal or a cholecystogastric fistula and subsequent migration of gallstone into the duodenum or pylorus of stomach, causing obstruction. The first case was reported by Leon Bouveret in 1896. We report a case illustrating the rarity and severity of this condition, together with a review of the literature of the different methods of endoscopic and surgical treatment.

Management of Bouveret Syndrome with Subsequent Gallstone Ileus

Videoscopy ◽

10.1089/vor.2020.0656 ◽

2020 ◽

Vol 30 (4) ◽

Author(s):

Mark E. Mahan ◽

Apurva K. Trivedi ◽

Brendan Hawara ◽

Ryan D. Horsley

Keyword(s):

Gallstone Ileus ◽

Bouveret Syndrome: Variant of Gallstone Ileus

Cirugía Española (English Edition) ◽

10.1016/j.cireng.2013.02.007 ◽

2014 ◽

Vol 92 (1) ◽

pp. e3

Author(s):

Pablo Calvo Espino ◽

Arturo García Pavía ◽

Mariano Artés Caselles ◽

Víctor Sánchez Turrión

Keyword(s):

Gallstone Ileus ◽

Bouveret syndrome - a rare variant of gallstone ileus

10.22541/au.161034270.03190308/v1 ◽

2021 ◽

Author(s):

Ana Alves ◽

João Louro ◽

Raquel Maia

Keyword(s):

Gastrointestinal Tract ◽

Rare Variant ◽

Clinical Presentation ◽

Gallstone Ileus ◽

Outlet Obstruction ◽

Bouveret syndrome is a rare cause of gastric outlet obstruction by passage of gallstone through a fistula between the gallbladder and proximal gastrointestinal tract, it is considered a proximal form of gallstone ileus. The clinical presentation is nonspecific, and imaging plays an important role in the diagnosis of this entity.

Bouveret-szindróma

Orvosi Hetilap ◽

10.1556/650.2021.32294 ◽

2021 ◽

Vol 162 (49) ◽

pp. 1982-1986

Keyword(s):

Elderly Women ◽

Epigastric Pain ◽

Outlet Obstruction ◽

Abdominal Ultrasound ◽

Therapeutic Options ◽

Upper Gastrointestinal Endoscopy ◽

Rare Form ◽

Bouveret Syndrome ◽

Upper Gastrointestinal

Összefoglaló. A Bouveret-szindróma egy bilioenteralis fistulán keresztül a vékonybélbe – az esetek 85%-ában a duodenumba – jutó nagy epekő okozta bélelzáródást jelenti. Leggyakrabban idős nők körében fordul elő. Jelen közleményünk célja e kórkép tüneteinek, diagnosztikájának és terápiás lehetőségeinek ismertetése egy esetbemutatás kapcsán. A 79 éves nőbeteg felvételi hasi panaszainak hátterében típusos gyomorkimenet-obstrukciós szindrómát okozó, a duodenumban beékelődött epekő, Bouveret-szindróma igazolódott. A diagnózist az elvégzett natív hasi röntgen és hasi ultrahangvizsgálatok már felvetették, de megerősítésére további képalkotó vizsgálatot (hasi CT) és endoszkópos beavatkozást végeztünk. Ezt követően sebészeti beavatkozás történt, melynek során a cholecystoduodenalis fistula zárása és az epekő eltávolítása után a beteg gyógyultan távozott. Közleményünkben a diagnózisfelállítás idejének fontosságáról, illetve a terápiás lehetőségekről számolunk be, valamint szeretnénk felhívni a figyelmet az epekő okozta gyomorürülési zavar ezen ritka formájára. Orv Hetil. 2021; 162(49): 1982–1986. Summary. Bouveret syndrome is a rare form of bowel obstruction resulting to the small intestine – in 85% of the cases to the duodenum – caused by a gallstone from a bilioenteral fistula. It occurs most commonly in elderly women. The aim of the present study is to describe the symptoms, diagnostic and therapeutic options of Bouveret syndrome due to our case report. The background of epigastric pain of the 79-year-old woman was the typical gastric outlet obstruction syndrome caused by Bouveret syndrome with an impacted gallstone into the duodenum. This diagnosis was suggested by abdominal X-ray and abdominal ultrasound; however, it was confirmed with abdominal computer tomography and upper gastrointestinal endoscopy. This was followed by surgical intervention to close the cholecystoduodenal fistula and remove the gallstone, finally the cured patient was discharged. In our study, we summarize the importance of timely diagnosis and therapeutic options, respectively, furthermore, draw attention to this rare form of gallstone-caused gastric outlet obstruction syndrome. Orv Hetil. 2021; 162(49): 1982–1986.

Bouveret Syndrome—The Rarest Variant of Gallstone Ileus: A Case Report and Literature Review

Case Reports in Surgery ◽

10.1155/2013/839370 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Vasileios K. Mavroeidis ◽

Dimitrios I. Matthioudakis ◽

Nikolaos K. Economou ◽

Ioannis D. Karanikas

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Gallstone Ileus ◽

Surgical Techniques ◽

Outlet Obstruction ◽

Cholecystoduodenal Fistula ◽

Endoscopic Techniques ◽

History Of ◽

Bouveret Syndrome ◽

The Right

We present a case report of a patient with Bouveret syndrome with interesting radiological findings and successful surgical treatment after failure of the endoscopic techniques. The report is followed by a review of the literature regarding the diagnostic means and proper treatment of this rare entity. Bouveret syndrome refers to the condition of gastric outlet obstruction caused by the impaction of a large gallstone into the duodenum after passage through a cholecystoduodenal fistula. Many endoscopic and surgical techniques have been described in the management of this syndrome. This is a case of a 78-year-old patient with severe medical history who presented in bad general condition with an 8-day history of nausea, multiple bilious vomiting episodes, anorexia, discomfort in the right hypochondrium and epigastrium, and fever up to 38,5°C. The diagnosis of Bouveret syndrome was set after performing the proper imaging studies. An initial endoscopic effort to resolve the obstruction was performed without success. Surgical treatment managed to extract the impacted gallstone through an enterotomy after removal into the first part of the jejunum.