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Updated: May 26, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Gastrointestinal bleeding and bowel obstruction as a presentation of Bouveret syndrome
Mónica Mengual-Ballester1, María Pilar Guillén-Paredes, María José Cases-Baldó
1Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario "Morales Meseguer," Murcia, Spain. mmengual@msn.com
Background:
Bouveret syndrome is a rare entity consisting of duodenal obstruction due to a gallstone from the gallbladder.
Clinical Cases:
We present two patients with very different ages and comorbidities whose conditions were resolved in two different ways: a 41-year-old female with right upper quadrant pain and vomiting who underwent surgical correction of obstruction and fistula, and an 81-year-old female with a high bowel obstruction, only treating the obstruction without intervention of the fistula.
Conclusions:
It is important to include high gastrointestinal obstruction in the differential diagnosis. Diagnosis can be made either by radiological or endoscopic techniques and therapeutic options are diverse, ranging from endoscopic removal to surgery (with the resolution of obstruction and fistula in the same surgical procedure). This condition usually affects elderly patients with high comorbidities and high surgical risk; therefore, most authors recommend using the most conservative possible treatment.
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