Bouveret’s Syndrome – Case Report

Rahelić, Velimir; Zelić, Miomir; Grbas, Harry; Depolo, Arsen; Kezele, Borivoj

doi:10.1055/s-0028-1098694

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…The treatment choice for Bouveret's syndrome remains debatable and can include endoscopic treatment, extracorporeal shockwave lithotripsy, intracorporeal electrohydraulic lithotripsy, surgery and laparoscopic treatment [9] . Currently, 1-stage or 2-stage surgery is often adopted [10][11][12] . One-stage surgery refers to a combination of enterolithotomy plus cholecystectomy and fistula repair within a single surgery.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of an upper gastrointestinal obstruction due to Bouveret’s syndrome

Yang¹

2013

WJG

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Bouveret's syndrome is an extremely rare type of gallstone-induced ileus with atypical clinical manifestations, such as abdominal distension and pain, nausea and vomiting, fever or even gastrointestinal bleeding, which may easily be misdiagnosed. In the present case, a 55-year-old male was admitted to the hospital with upper gastrointestinal obstructive symptoms but without pain, fever, jaundice or melena. At first, gastrolithiasis and peptic ulcer combined with pyloric obstruction were suspected after gastroscopy revealed a large, hard stone in the duodenal bulb. A revised diagnosis of Bouveret's syndrome was made following abdominal computed tomography. Subsequently, the patient exhibited a good postoperative recovery after laparoscopic duodenotomy for gallstone removal and subtotal cholecystectomy. The condition of the patient remained stable after being followed up for 6 mo. The successful application of laparoscopic therapy to treat Bouveret's syndrome has seldom been reported. Laparoscopic enterolithotomy is safe and effective, with good patient tolerability, rapid postoperative recovery and few wound-related complications. The laparoscopic treatment of Bouveret's syndrome is worth exploring.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of an upper gastrointestinal obstruction due to Bouveret’s syndrome

Yang¹

2013

WJG

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“…A small number of reports in the medical literature have recorded the passage of gallstones into the gastrointestinal tract following an ERCP or Mirizzi syndrome, where a cholecystocholedochal fistula is formed [8][9][10]. After its passage, the stone can migrate both distally or proximally to the duodenum and stomach (Bouveret's syndrome) [11][12][13]. Our patient presented a gallstone impacted in the proximal jejunum, approximately 20 cm distal from the ligament of Treitz, which is a particularly rare localization.…”

Section: Discussionmentioning

confidence: 99%

High small bowel obstruction from a gallstone

et al. 2010

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Gallstones are a very uncommon cause of obstruction at any site of the gastrointestinal tract and commonly affect the elderly. The mechanism by which the stones pass into the intestine is a biliary-enteric fistula, more often after an episode of acute cholecystitis. Radiologic studies may prove very helpful in diagnosis, but a high index of suspicion and accurate medical history are also warranted. We present the case of a 77-year-old patient who was admitted with signs of acute cholecystitis. During his hospitalization, he developed symptoms of small bowel obstruction. Imaging studies revealed an obstacle in the proximal intestine and the patient underwent exploratory laparotomy which identified a 5 cm gallstone lodged in the proximal jejunum; an enterolithotomy was performed. Surgical options in such cases are affected by the general condition of the patient and the extent of the inflammatory and ischemic process at the affected organs. Despite developments, this clinical entity still carrries high mortality rates. This could be attributed to the comorbidities of the elderly and the fact that it remains a rare and difficult diagnostic entity.

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Novel treatment options for Bouveret’s syndrome: a comprehensive review of 61 cases of successful endoscopic treatment

Dumonceau

Devière

2016

Expert Review of Gastroenterology & Hepatology

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In Bouveret's syndrome, a biliary stone obstructs the duodenum. Surgical treatment is plagued by high morbidity and mortality. Therefore, endoscopic treatment has become a first-line approach. Areas covered: A literature search of Medline and Google Scholar databases was performed using the terms endoscopic treatment, non-operative treatment, Bouveret's syndrome, and gallstone ileus. Sixty-one cases of successful endoscopic treatment were found over the period 1978-2016 and are summarized herein. Therapeutic modalities used in 52 patients with complete success included mechanical lithotripsy (40% of cases), electrohydraulic lithotripsy (21% of cases), extraction of the intact stone and laser lithotripsy (15% of cases each), extracorporeal shockwave lithotripsy and duodenal stenting (4% of cases each). In the remaining 9 patients, stone fragments migrated distally and required surgical removal. Cholecystectomy was performed in five (8.2%) of 61 patients and gallbladder cancer was detected in three (4.9%) patients. Expert commentary: Meticulous preparation, including that of instruments, personnel, patient anesthesia, and X-ray availability, is key to success in this unusual situation. Partial success (stone fragmentation and mobilization to another location) may render surgery easier as these patients present with dense adherences in the right upper quadrant. Cholecystectomy is reserved for highly selected patients (e.g. relapsing ileus, gallbladder cancer).

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Bouveret’s Syndrome – Case Report

Cited by 5 publications

References 4 publications

Laparoscopic treatment of an upper gastrointestinal obstruction due to Bouveret’s syndrome

Laparoscopic treatment of an upper gastrointestinal obstruction due to Bouveret’s syndrome

High small bowel obstruction from a gallstone

Novel treatment options for Bouveret’s syndrome: a comprehensive review of 61 cases of successful endoscopic treatment

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