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Bouveret's syndrome: case report and review of the literature.

Doycheva I, Limaye A, Suman A, Forsmark CE, Sultan S - Gastroenterol Res Pract (2009)

Bottom Line: Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula.Initial attempts at endoscopic retrieval with or without mechanical or extracorporeal lithotripsy should be performed as first-line treatment, though success rates with endoscopic treatment are variable.We describe a case of Bouveret's Syndrome in an elderly patient that was successfully treated with endoscopic extraction combined with mechanical lithotripsy, and review the literature on this uncommon condition.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Hepatology, and Nutrition, College of Medicine, University of Florida, Gainesville, FL 32611, USA.

ABSTRACT
Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula. Initial attempts at endoscopic retrieval with or without mechanical or extracorporeal lithotripsy should be performed as first-line treatment, though success rates with endoscopic treatment are variable. We describe a case of Bouveret's Syndrome in an elderly patient that was successfully treated with endoscopic extraction combined with mechanical lithotripsy, and review the literature on this uncommon condition.

No MeSH data available.


Related in: MedlinePlus

Fistula and surrounding ulceration of the duodenum on endoscopy.
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Related In: Results  -  Collection


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fig3: Fistula and surrounding ulceration of the duodenum on endoscopy.

Mentions: Initial esophagogastroduodenoscopy (EGD) revealed large amounts of fluid and food content in the stomach with poor visualization of the duodenum due to retained food and a large stone in the second part of duodenum causing complete obstruction of its lumen (Figure 2). Extensive ulceration of the duodenal wall at the point where the stone was impacted was also seen. The patient was brought back the following day for attempted stone extraction, at which time the stone was successfully removed from the duodenum and transferred to the stomach using various devices including a retrieval net, snare, stone extracting basket, and lithotripsy basket. A cholecystoduodenal fistula was visualized beneath the level of the stone on subsequent endoscopy (Figure 3). The stone was then successfully crushed into smaller fragments using a mechanical lithotripter. After successful endoscopic treatment, the patient's symptoms resolved and he was discharged home with close follow-up as an outpatient.


Bouveret's syndrome: case report and review of the literature.

Doycheva I, Limaye A, Suman A, Forsmark CE, Sultan S - Gastroenterol Res Pract (2009)

Fistula and surrounding ulceration of the duodenum on endoscopy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2666152&req=5

fig3: Fistula and surrounding ulceration of the duodenum on endoscopy.
Mentions: Initial esophagogastroduodenoscopy (EGD) revealed large amounts of fluid and food content in the stomach with poor visualization of the duodenum due to retained food and a large stone in the second part of duodenum causing complete obstruction of its lumen (Figure 2). Extensive ulceration of the duodenal wall at the point where the stone was impacted was also seen. The patient was brought back the following day for attempted stone extraction, at which time the stone was successfully removed from the duodenum and transferred to the stomach using various devices including a retrieval net, snare, stone extracting basket, and lithotripsy basket. A cholecystoduodenal fistula was visualized beneath the level of the stone on subsequent endoscopy (Figure 3). The stone was then successfully crushed into smaller fragments using a mechanical lithotripter. After successful endoscopic treatment, the patient's symptoms resolved and he was discharged home with close follow-up as an outpatient.

Bottom Line: Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula.Initial attempts at endoscopic retrieval with or without mechanical or extracorporeal lithotripsy should be performed as first-line treatment, though success rates with endoscopic treatment are variable.We describe a case of Bouveret's Syndrome in an elderly patient that was successfully treated with endoscopic extraction combined with mechanical lithotripsy, and review the literature on this uncommon condition.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Hepatology, and Nutrition, College of Medicine, University of Florida, Gainesville, FL 32611, USA.

ABSTRACT
Bouveret's syndrome is defined as gastric outlet obstruction caused by duodenal impaction of a large gallstone which passes into the duodenal bulb through a cholecystogastric or cholecystoduodenal fistula. Initial attempts at endoscopic retrieval with or without mechanical or extracorporeal lithotripsy should be performed as first-line treatment, though success rates with endoscopic treatment are variable. We describe a case of Bouveret's Syndrome in an elderly patient that was successfully treated with endoscopic extraction combined with mechanical lithotripsy, and review the literature on this uncommon condition.

No MeSH data available.


Related in: MedlinePlus