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Gastric Outlet Obstruction Due to Cholecysto-Gastric Fistula: Bouveret’s Syndrome

  • Savas Sezik1
  • Mustafa Sever1
  • Nezih Kavak2
  • Ahmet Burak Erdem3

1Department of Emergency Medicine, Tepecik Educational and Research Hospital, Izmir, Turkey

2Department of Emergency Medicine, Yildirim Beyazit Diskapi Educational and Research Hospital, Ankara, Turkey

3Department of Emergency Medicine, Ankara Numune Educational and Research Hospital, Ankara, Turkey

DOI: 10.22514/sv.2020.16.0036 Vol.17,Issue 1,January 2021 pp.209-212

Published: 08 January 2021

*Corresponding Author(s): Mustafa Sever E-mail: adanasever@yahoo.com

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Abstract

Bouveret’s syndrome is defined as gastrointestinal obstruction due to an impacted gallstone secondary to biliary-enteric fistula. This is often observed with nonspecific symptoms such as epigastric pain, nausea, and vomiting. The diagnosis is made by visualization of pneumobilia, gastric outlet obstruction and ectopic gallstone. In this report, we discussed an elderly patient who was admitted to the emergency department with abdominal pain and vomiting without any signs of bowel obstruction in plain x-ray and ultrasound imaging. We aimed to remind the importance of clinical suspicion and the diagnostic value of computed abdominal tomography for emergency physicians.

Keywords

Abdominal pain, Bouveret’s syndrome, Computed tomography, Elderly, Emergency department

Cite and Share

Savas Sezik,Mustafa Sever,Nezih Kavak,Ahmet Burak Erdem. Gastric Outlet Obstruction Due to Cholecysto-Gastric Fistula: Bouveret’s Syndrome. Signa Vitae. 2021. 17(1);209-212.

URL:

https://www.signavitae.com/articles/10.22514/sv.2020.16.0036

References

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[2] Arioli D, Venturini I, Masetti M, et al. Intermittent gastric outlet obstruction due to a gallstone migrated through a cholecysto-gastric fistula: a new variant of Bouveret’s syndrome. World J Gastroenterol. 2008;14:125-128.

[3] Matur R, Yucel T, Gurdal SO, et al. Bouveret Sendromu: Safra Tasına Baglı Mide Çıkıs Obstruksiyonu. Ulus Travma Derg. 2002;8:179-182.

[4] Petrowsky H., Pierre-A.C. “Biliary fistula, gallstone ileus and Mirizzi’s syndrome” In: Clavien P.A., Baillie J. Disease of the gallbladder and bile ducts: Diagnosis and treatment; 2006. p. 239-48.

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[6] Gajendran M, Muniraj T, Gelrud A. A challenging case of gastric outlet obstruction (Bouveret’s syndrome): A case report. J Med Case Rep. 2011;4: 497.

[7] Yakan S, Engin Ö. Gallstone ileus as an unexpected complication of cholelithiasis: diagnostic difficulties and treatment. Ulus Travma Acil Cerrahi Derg. 2010;16:344-348.

[8] Pickhardt PJ, Friedland JA, Hruza DS, et al. CT, MR cholangiopan-creatography, and endoscopy findings in Bouveret’s syndrome. Am J Roentgenol. 2003;180:1033-1035.

[9] Doycheva I, Limaye A, Suman A, et al. Bouveret’s syndrome: Case report and review of the literature. Gastroenterol Res Pract. 2009;2009:914-951.

[10] David Q.-H. Wang and Nezam H. Afdhal. Section VIII: Bil-iary Tract. Chapter 65: Gallstone Disease. In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. Pathophysiol-ogy/Diagnosis/Management. Eds.: Feldman M, Friedman LS, Brandt LJ. E-Book. 9th Ed. Saunders-Elsevier. Pp: 1089-1119.

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