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Bouveret's syndrome: a case report
Nicola Busi1, Giada Maria Benedetta Giannino, Raffaele Dalla Valle
1Institute of General Surgery and Organ Transplantation, University of Parma.
Chirurgia Italiana
|August 4, 2004
Summary
Bouveret's syndrome, a rare gallstone complication causing duodenal obstruction, presents with vomiting and dehydration. Surgical intervention offers effective treatment for both the obstruction and the underlying fistula.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
Background:
- Gallstone disease can rarely lead to Bouveret's syndrome, characterized by a cholecystoduodenal fistula causing duodenal obstruction.
- This condition presents with symptoms of gastric outlet obstruction, including vomiting, abdominal distension, and dehydration.
Observation:
- Diagnostic imaging like abdominal X-rays, ultrasonography, and CT scans can reveal pneumobilia and the obstructing gallstone.
- Endoscopy is crucial for diagnosis and can sometimes relieve the obstruction, but is often unsuccessful for large stones and cannot treat the fistula.
Findings:
- Surgical therapy is effective for both relieving the duodenal obstruction and treating the cholecystoduodenal fistula.
- A case of Bouveret's syndrome was successfully treated surgically in an otherwise healthy patient.
Implications:
- Surgical management is the definitive treatment for Bouveret's syndrome, addressing both the acute obstruction and the causative fistula.
- In critically ill patients, the immediate priority is relieving the gastric outlet obstruction.