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[Duodenal biliary ileus].

P Simici, O Raţiu, F Popa

    Revista De Chirurgie, Oncologie, Radiologie, O.R.L., Oftalmologie, Stomatologie. Chirurgie
    |July 1, 1981
    PubMed
    Summary
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    This case report details a rare instance of Bouveret's syndrome, involving a double bilio-digestive fistula causing biliary ileus. Surgical intervention included cholecystectomy and gastro-jejunal anastomosis to manage the complex duodenal obstruction.

    Area of Science:

    • Gastroenterology and Hepatobiliary Surgery
    • Clinical Case Studies
    • Surgical Pathology

    Background:

    • Bouveret's syndrome is a rare complication of gallstones, characterized by gastric outlet or duodenal obstruction.
    • It results from a cholecystoenteric fistula, most commonly a cholecystoduodenal fistula.
    • This report highlights a unique variant with a double fistula.

    Observation:

    • A patient presented with emergency symptoms of biliary ileus due to a gallstone impacted in the duodenum.
    • Intraoperative findings revealed a rare double bilio-digestive fistula: cholecystogastric and cholecystoduodenal.
    • The extensive lesions necessitated a complex surgical approach.

    Findings:

    • The patient had a double bilio-digestive fistula, a highly unusual presentation of Bouveret's syndrome.

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  • Surgical management involved cholecystectomy, antrectomy, and gastro-jejunal anastomosis.
  • The duodenum was excluded from the digestive pathway post-surgery.

    • Implications:

    • This case underscores the importance of considering rare fistula formations in diagnosing biliary ileus.
    • The surgical strategy employed demonstrates an effective, albeit exceptional, solution for complex cases.
    • Management of such rare conditions requires tailored surgical expertise and decision-making.