Bouveret's Syndrome: A Diagnostic and Therapeutic Approach to an Unusual Complication of Cholelithiasis

Bouveret's syndrome is a rare form of bowel obstruction caused by the impaction of a large gallstone through a cholecystoduodenal fistula, leading to gastric outlet obstruction. This article aims to highlight the clinical presentation and management of this syndrome, given its low incidence and high mortality rate of 12% to 30%. We present the case of an 83-year-old patient with a history of diabetes and hypertension who presented with abdominal pain, distension, and vomiting. Computed tomography revealed duodenal obstruction due to a large gallstone. A diagnostic laparotomy was performed, allowing for the removal of the stone through enterotomy. The patient had an uncomplicated recovery and was discharged on the seventh day of hospitalization. Early diagnosis and effective management are crucial, with endoscopy as the preferred initial treatment, although surgery may be necessary if endoscopy fails. Tailoring the treatment to the patient's condition is essential to improving outcomes and reducing associated mortality.