Bouveret Syndrome in an Elderly Female

Article Sidebar

PDF HTML
Submitted: December 26, 2016
Published: Jan 3, 2017
DOI: 10.29328/journal.ascr.1001002
Keywords:
Bouveret syndrome, Elevated liver enzymes, Bowel obstruction, Fistulae, Duodenal obstruction, Surgery, Elderly

Main Article Content

Zvi H. Perry
Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Udit Gibor
Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Shahar Atias
Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Solly Mizrahi
Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Alex Rosental
Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
Boris Kirshtein
Department of Surgery A, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Abstract

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.

Article Details

Perry, Z. H., Gibor, U., Atias, S., Mizrahi, S., Rosental, A., & Kirshtein, B. (2017). Bouveret Syndrome in an Elderly Female. Archives of Surgery and Clinical Research, 1(1), 012–015. https://doi.org/10.29328/journal.ascr.1001002
Case Reports

Copyright (c) 2017 Perry ZH, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

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

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

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

Mumoli N, Cei M, Luschi R, Carmignani G, Orlandi F. Bouveret syndrome. Emerg Med J. 2010; 277: 525. Ref.: https://goo.gl/SjholH

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

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

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