The curious case of biliary emesis and bowel obstruction from Bouveret syndrome

BMJ Case Rep. 2019 Aug 28;12(8):e230194. doi: 10.1136/bcr-2019-230194.

Abstract

Bouveret syndrome is a rare complication of biliary lithiasis. This sequela is caused by the passage of the gallstone via a bilioenteric fistula, resulting in an impacted gallstone in the duodenum or stomach. The common presentation of non-specific symptoms contributes to the diagnostic uncertainty and delay, which is strongly associated with adverse outcomes. We report an uncomplicated stone extraction via open gastrotomy in an elderly man afflicted with bowel obstruction and biliary vomit secondary to Bouveret syndrome.

Keywords: endoscopy; gastrointestinal surgery; pancreas and biliary tract; stomach and duodenum.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biliary Fistula / complications
  • Biliary Tract / pathology*
  • Duodenal Obstruction / diagnostic imaging
  • Duodenal Obstruction / etiology*
  • Duodenum / diagnostic imaging
  • Endoscopy, Digestive System / methods
  • Gallstones / complications
  • Gallstones / surgery
  • Gastric Outlet Obstruction / etiology*
  • Gastric Outlet Obstruction / surgery
  • Humans
  • Laparotomy / methods
  • Male
  • Stomach / pathology
  • Stomach / surgery*
  • Syndrome
  • Treatment Outcome
  • Vomiting / etiology*