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Updated: Dec 4, 2025

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Duodenal bulb obstruction caused by a gallstone (Bouveret syndrome) successfully treated with endoscopic measures
Gilles Jadd Hoilat1, Vanessa Sostre2, Judie N Hoilat3
1Department of Medicine, State University of New York Upstate Medical University, Syracuse, New York.
Abstract:
Bouveret syndrome is the rarest variant of gallstone ileus, with a high morbidity and mortality rate as well as life-threatening complications. We present a case of an 86-year-old woman who presented with abdominal pain and was diagnosed with acute cholecystitis. After laparoscopic cholecystectomy, her symptoms did not improve. She then underwent endoscopic retrograde cholangiopancreatography and was found to have a stone causing duodenal bulb obstruction. The stone was removed using a snare, and her symptoms improved greatly. This rare case of Bouveret syndrome with no apparent fistula was successfully treated using endoscopic measures.
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