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Bouveret's syndrome--case report
1Department of Abdominal Surgery, University Hospital Rijeka, Rijeka, Croatia.
Zentralblatt Fur Chirurgie
|June 19, 2009
Summary
Bouveret's syndrome, a rare cause of gastric outlet obstruction from gallstones, typically requires surgery. This case highlights surgical management after failed endoscopic treatment for a large 7-cm stone.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Biliary System Pathologies
Background:
- Bouveret's syndrome is a rare complication of cholelithiasis (gallstones) causing gastric outlet obstruction.
- It results from a gallstone forming a fistula between the gallbladder/biliary tree and the stomach or duodenum.
- Standard treatments include surgical enterolithotomy or gastrotomy, with endoscopic extraction as an alternative.
Observation:
- An 80-year-old female presented with symptoms of pyloric obstruction.
- She had a history of cholelithiasis but no prior biliary colic episodes.
- A large 7-cm gallstone was identified as the cause of obstruction.
Findings:
- Endoscopic treatment failed to remove the obstructing gallstone.
- Emergency surgery via pylorotomy was performed for gallstone removal.
- The patient experienced a postoperative wound infection but recovered.
Implications:
- Surgical intervention remains crucial for large gallstones causing Bouveret's syndrome, especially when endoscopic methods fail.
- This case underscores the importance of surgical expertise in managing complex gallstone-related gastric outlet obstruction.
- Prompt surgical management can lead to favorable outcomes despite complications.
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