Bouveret Syndrome or Gallstone Ileus

Alibegovic, Ervin; Kurtcehajic, Admir; Hujdurovic, Ahmed; Mujagić, Svjetlana; Alibegovic, Jasminka; Kurtcehajic, Dzenita

doi:10.1016/j.amjmed.2017.10.044

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…The obstruction can occur at different gastrointestinal tract levels but more commonly at the terminal ileum and the ileocecal valve [5,8,9]. Other mechanisms of GSI involve the passage of gallstone through the Vater papilla following an ERCP and sphincterotomy, and gallstone dislodged from a diverticulum, causing obstruction and Fistula between the bile ducts and intestine [4,10,11]. In 2021, Sequndo et al reported different mechanisms and extraordinary clinical presentation of GSI in cholecystoectomized patients [4].…”

Section: Discussionmentioning

confidence: 99%

Gallstone Ileus in the Absence of Gallbladder, Rare Etiology of Bowel Obstruction: A Case Report and Literature Review

Alenezi¹,

Alenezi²,

Saleem³

et al. 2023

AJSCR

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Background: Gallstone ileus post-cholecystectomy is extremely rare surgical emergency causing mechanical bowel obstruction. This condition is usually misdiagnosed due to its non-specific clinical features. Radiological investigations are essential to evaluate and diagnose gallstone ileus cases. Case Presentation: A 92-year-old female patient, cholecystomized, presented to our hospital with a one-week history of an acute confusional state, generalized abdominal pain, and vomiting. The physical examination showed a disoriented patient with a distended abdomen and generalized tenderness, especially in the epigastric area. Hyperactive bowel sounds were audible. Laboratory investigations were non-specific. A plain abdominal X-ray was insignificant. The abdominal ultrasound showed marked abdominal gaseous distention. Then, an abdominal CT scan was performed, revealing an impression of gallstone ileus causing small bowel obstruction with no evidence of fistula formation. So, surgical intervention was decided, and an 8-gram gallstone was exteriorized through an enterolithotomy. The postoperative period was uneventful. Discussion: Gallstone ileus is an unusual entity that often affects elderly females. The clinical features of gallstone ileus include abdominal pain, abdominal distension, nausea, and vomiting. Diagnosis of gallstone ileus relies on imaging and physical examination. Abdominal CT with contrast provides a definitive diagnostic tool. The surgical options to manage the gallstone ileus can be either one or two-staged enterolithotomy. Conclusion: Due to the rare etiologic origin of the gallstone ileus in post-cholecystectomy cases, we report the case of a 92-year-old female with an acute confusional state and generalized abdominal pain, found to be caused by detected gallstone ileus, lacking evidence of fistula formation.

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Section: Discussionmentioning

confidence: 99%

Gallstone Ileus in the Absence of Gallbladder, Rare Etiology of Bowel Obstruction: A Case Report and Literature Review

Alenezi¹,

Alenezi²,

Saleem³

et al. 2023

AJSCR

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“…In case of cholecystocolonic fistula, the gallstone usually obstructs the sigmoid colon [8] . Fistulas with stomach mostly obstruct the gastric pylorus, causing Bouveret's syndrome, and it can also occur in cauculi from the duodenum that migrates against peristalsis [9] . In very rare and poorly documented cases, the gallstone that migrates from a cholecystogastric fistula surpasses the pylorus with few or no symptoms, obstructing in another point of the intestinal transit, as in the case reported [2] , [10] .…”

Section: Discussionmentioning

confidence: 99%

Gallstone ileus associated with cholecystogastric fistula: Case report, diagnosis and surgical treatment

Rodriguez

Grossi

Siqueira

et al. 2021

International Journal of Surgery Case Reports

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Introduction Gallstone Ileus is a rare complication of cholelithiasis, associated with multiple episodes of cholecystitis, with the formation of adhesions and fistulas between the gallbladder and adjacent organs. Its diagnosis is difficult, requiring complementary imaging tests such as computed tomography or radiography. Presentation of case Female patient, with intestinal obstruction for 7 days, associated with abdominal pain and previous episodes of pain in the right hypochondrium for 3 months. Abdominal CT scan identified aerobilia, gallstone impacted in the ileocecal valve and small loop dilatation, in addition to a probable cholecystogastric fistula. Opted for exploratory laparotomy, enterolithotomy and fistula correction in one surgical time. Discussion Gallstone ileus is rare among the complications of cholelithiasis, in addition to the fact that cholecystogastric fistula is associated with gastric pylorus obstruction and not impaction on the ileocecal valve. Imaging tests are useful to complement the diagnosis, and if Rigler's triad is present, the suspicion of gallstone ileus is increased. The presence of fistula between the gallbladder and stomach presents a frequency between 0 and 13.3%. There is no gold standard treatment for gallstone ileus, but surgery options for each type of patient and severity level. Conclusion There is no definitive protocol for optimal surgical treatment for biliary ileus, but the possibility of enterolithotomy associated with cholecystectomy and fistula correction can be evaluated in selected patients.

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“…Other reported causes include Bouveret syndrome (an impacted gallstone in the proximal duodenum), phytobezoar, diaphragmatic hernia, gastric volvulus, and Ladd bands (peritoneal bands associated with intestinal malrotation). 7,28,29 ■ PRESENTING SYMPTOMS Symptoms of gastric outlet obstruction include nausea, nonbilious vomiting, epigastric pain, early satiety, abdominal distention, and weight loss.…”

Section: Less Peptic Ulcer Disease But Still Commonmentioning

confidence: 99%