Case Report

Bouveret Syndrome in an Elderly Female

Zvi H. Perry*, Udit Gibor, Shahar Atias, Solly Mizrahi, Alex Rosental and Boris Kirshtein

Published: 03 January, 2017 | Volume 1 - Issue 1 | Pages: 012-015

Introduction: A gastric outlet obstruction secondary to a gallstone ileus is known as Bouveret syndrome. Herein we present a case of an elderly woman with an impacted gallstone in duodenum and discuss its’ management.

Patient description: A 96-year-old woman was admitted to our department due to a gastric outlet obstruction. Initial gastroscopy revealed a gastric bezoar. An attempt for its extraction failed. She underwent a laparotomy in which a cholecystoduodenal fistula and a large impacted stone were found. Separation of the fistula, including closure of the duodenum side, cholecystectomy and removal of the obstructing gallstone were performed. Additional stones were found and retrieved during common bile duct (CBD) exploration. Surgery was finalized by duodenoplasty, closure and T-tube drainage of the CBD. Post-operative course was prolonged and uneventful.

Discussion and Conclusions: Bouveret syndrome is a rare cause of gastric outlet obstructions. In this case, unsuccessful endoscopic treatment necessitated surgery for removal of impacted gallstone in the duodenum.

Read Full Article HTML DOI: 10.29328/journal.ascr.1001002 Cite this Article Read Full Article PDF


Bouveret syndrome; Elevated liver enzymes; Bowel obstruction; Fistulae; Duodenal obstruction; Surgery; Elderly


  1. Artioli G, Muri M, Praticò FE, Marcantoni EA, Gazzani SE, et al. Gallstone ileus: literature review. Acta Biomed 2016; 87: 40-44. Ref.: https://goo.gl/UhDzKy
  2. Giese A, Zieren J, Winnekendonk G, Henning BF. Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome) four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report. J Med Case Rep. 2010; 4: 376. Ref.: https://goo.gl/URhdsQ
  3. Yong E, Chiu TF, Kamel H, Yong E. To leave no stone unturned: cholelithiasis and subsequent gallstone ileus. BMJ Case Rep. 2016. Ref.: https://goo.gl/r4rTr0
  4. Mumoli N, Cei M, Luschi R, Carmignani G, Orlandi F. Bouveret syndrome. Emerg Med J. 2010; 277: 525. Ref.: https://goo.gl/SjholH
  5. Rossi D, Khan U, McNatt S, Vaughan R. Bouveret syndrome: a case report. W V Med J. 2010; 106: 18-22. Ref.: https://goo.gl/71s2Zs
  6. Gavrila D, Galusca C, Berbecel M, Boros M, Dumitrascu T. Bouveret Syndrome - An Exceptional Complication of a Very Frequent Disease. Chirurgia (Bucur). 2016; 111: 283-285. Ref.: https://goo.gl/n7Ixtq
  7. Vidal O, Seco JL, Alvarez A, Triñanes JP, Serrano LP, et al. Bouveret syndrome: 5 cases. Rev Esp Enferm Dig. 1994; 86: 839-844. Ref.: https://goo.gl/hTVgzd


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