Management of Bouveret syndrome with lithotripsy and transgastric stone retrieval

Bouveret syndrome describes an ectopic migrating gallstone resulting in gastric outlet obstruction via a cholecystoduodenal/cholecystogastric fistula. Due to its rarity, no current guidelines or formal consensus exist regarding its management or follow-up. We present a rare case of Bouveret syndrome in a man in his mid 80s. Attempts to endoscopically remove the impacted stone that caused the gastric outlet obstruction failed. We subsequently treated him with lithotripsy and gastrotomy alone with no further interventions, and contribute this case to existing literature regarding this complication of gallstone disease.