Gastrointestinal bleeding and bowel obstruction as a presentation of Bouveret syndrome

Mónica Mengual-Ballester; María Pilar Guillén-Paredes; María José Cases-Baldó; María Luisa García-García; José Luis Aguayo-Albasini

Gastrointestinal bleeding and bowel obstruction as a presentation of Bouveret syndrome

Cir Cir. 2011 Nov-Dec;79(6):557-9.

[Article in English, Spanish]

Authors

Mónica Mengual-Ballester¹, María Pilar Guillén-Paredes, María José Cases-Baldó, María Luisa García-García, José Luis Aguayo-Albasini

Affiliation

¹ Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario "Morales Meseguer," Murcia, Spain. [email protected]

PMID: 22169375

Abstract

Background: Bouveret syndrome is a rare entity consisting of duodenal obstruction due to a gallstone from the gallbladder.

Clinical cases: We present two patients with very different ages and comorbidities whose conditions were resolved in two different ways: a 41-year-old female with right upper quadrant pain and vomiting who underwent surgical correction of obstruction and fistula, and an 81-year-old female with a high bowel obstruction, only treating the obstruction without intervention of the fistula.

Conclusions: It is important to include high gastrointestinal obstruction in the differential diagnosis. Diagnosis can be made either by radiological or endoscopic techniques and therapeutic options are diverse, ranging from endoscopic removal to surgery (with the resolution of obstruction and fistula in the same surgical procedure). This condition usually affects elderly patients with high comorbidities and high surgical risk; therefore, most authors recommend using the most conservative possible treatment.

Publication types

Case Reports

MeSH terms

Abdominal Pain / etiology
Adult
Aged, 80 and over
Biliary Fistula / complications
Biliary Fistula / diagnostic imaging
Biliary Fistula / surgery
Cholecystectomy
Cholelithiasis / complications*
Cholelithiasis / surgery
Comorbidity
Duodenal Diseases / complications
Duodenal Diseases / diagnostic imaging
Duodenal Diseases / surgery
Duodenal Obstruction / complications
Duodenal Obstruction / diagnosis*
Duodenal Obstruction / diagnostic imaging
Female
Gallstones*
Gastric Bypass
Gastrointestinal Hemorrhage / etiology*
Humans
Intestinal Fistula / complications
Intestinal Fistula / diagnostic imaging
Intestinal Fistula / surgery
Postoperative Complications / surgery
Recurrence
Syndrome
Tomography, X-Ray Computed
Ultrasonography