Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports
<i>Introduction</i>: Bouveret syndrome, a rare and often underdiagnosed variant of gallstone ileus, is characterized by the presence of a large gallstone impacted in the proximal duodenum, resulting in significant gastric outlet obstruction and aerobilia. Early identification of Bouveret...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-12-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/1/5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832587969615101952 |
|---|---|
| author | Nebojsa S. Ignjatovic Ilija D. Golubovic Miodrag N. Djordjevic Marko M. Stojanovic Daniela A. Benedeto Stojanov Jelena S. Ignjatovic Jelena D. Zivadinovic Sonja Golubovic |
| author_facet | Nebojsa S. Ignjatovic Ilija D. Golubovic Miodrag N. Djordjevic Marko M. Stojanovic Daniela A. Benedeto Stojanov Jelena S. Ignjatovic Jelena D. Zivadinovic Sonja Golubovic |
| author_sort | Nebojsa S. Ignjatovic |
| collection | DOAJ |
| description | <i>Introduction</i>: Bouveret syndrome, a rare and often underdiagnosed variant of gallstone ileus, is characterized by the presence of a large gallstone impacted in the proximal duodenum, resulting in significant gastric outlet obstruction and aerobilia. Early identification of Bouveret syndrome is crucial for developing an appropriate surgical strategy. <i>Case 1</i>: A 76-year-old female underwent a contrast-enhanced abdominal CT scan, which revealed a cholecysto-duodenal fistula with a 3.9 cm × 4.0 cm × 4.0 cm gallstone located in the proximal duodenum, along with a distended, fluid-filled stomach and aerobilia. Intraoperatively, due to chronic inflammation and adhesion between the gallbladder and duodenum, a cholecystectomy and fistula repair were performed. <i>Case 2</i>: A 72-year-old female presented with a gastroduodenal passage obstruction confirmed by imaging, which identified a duodeno-biliary fistula. The radiological examination showed oval filling defects in the duodenal bulb consistent with Bouveret’s syndrome, with the largest stone measuring approximately 6 cm in diameter. An enterotomy was performed for stone extraction and was followed by cholecystectomy and duodenal repair with omentoplasty. <i>Conclusions</i>: Bouveret’s syndrome is a rare but clinically significant condition that should be considered in patients presenting with signs of upper gastrointestinal obstruction, particularly in those with a history of chronic cholelithiasis. Early recognition and prompt surgical intervention are essential for obtaining optimal patient outcomes. |
| format | Article |
| id | doaj-art-0cc6130232264e47b96a89008cf5a8e1 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-0cc6130232264e47b96a89008cf5a8e12025-01-24T13:40:13ZengMDPI AGMedicina1010-660X1648-91442024-12-01611510.3390/medicina61010005Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case ReportsNebojsa S. Ignjatovic0Ilija D. Golubovic1Miodrag N. Djordjevic2Marko M. Stojanovic3Daniela A. Benedeto Stojanov4Jelena S. Ignjatovic5Jelena D. Zivadinovic6Sonja Golubovic7Clinic for Digestive Surgery, University Clinical Centre Nis, 18000 Nis, SerbiaClinic for Digestive Surgery, University Clinical Centre Nis, 18000 Nis, SerbiaMedical Faculty, University of Nis, 18000 Nis, SerbiaMedical Faculty, University of Nis, 18000 Nis, SerbiaMedical Faculty, University of Nis, 18000 Nis, SerbiaMedical Faculty, University of Nis, 18000 Nis, SerbiaMedical Faculty, University of Nis, 18000 Nis, SerbiaMedical Faculty, University of Nis, 18000 Nis, Serbia<i>Introduction</i>: Bouveret syndrome, a rare and often underdiagnosed variant of gallstone ileus, is characterized by the presence of a large gallstone impacted in the proximal duodenum, resulting in significant gastric outlet obstruction and aerobilia. Early identification of Bouveret syndrome is crucial for developing an appropriate surgical strategy. <i>Case 1</i>: A 76-year-old female underwent a contrast-enhanced abdominal CT scan, which revealed a cholecysto-duodenal fistula with a 3.9 cm × 4.0 cm × 4.0 cm gallstone located in the proximal duodenum, along with a distended, fluid-filled stomach and aerobilia. Intraoperatively, due to chronic inflammation and adhesion between the gallbladder and duodenum, a cholecystectomy and fistula repair were performed. <i>Case 2</i>: A 72-year-old female presented with a gastroduodenal passage obstruction confirmed by imaging, which identified a duodeno-biliary fistula. The radiological examination showed oval filling defects in the duodenal bulb consistent with Bouveret’s syndrome, with the largest stone measuring approximately 6 cm in diameter. An enterotomy was performed for stone extraction and was followed by cholecystectomy and duodenal repair with omentoplasty. <i>Conclusions</i>: Bouveret’s syndrome is a rare but clinically significant condition that should be considered in patients presenting with signs of upper gastrointestinal obstruction, particularly in those with a history of chronic cholelithiasis. Early recognition and prompt surgical intervention are essential for obtaining optimal patient outcomes.https://www.mdpi.com/1648-9144/61/1/5Bouveret’s syndromegallstone ileuscholecystectomysurgical strategyduodeno-biliary fistula |
| spellingShingle | Nebojsa S. Ignjatovic Ilija D. Golubovic Miodrag N. Djordjevic Marko M. Stojanovic Daniela A. Benedeto Stojanov Jelena S. Ignjatovic Jelena D. Zivadinovic Sonja Golubovic Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports Medicina Bouveret’s syndrome gallstone ileus cholecystectomy surgical strategy duodeno-biliary fistula |
| title | Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports |
| title_full | Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports |
| title_fullStr | Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports |
| title_full_unstemmed | Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports |
| title_short | Bouveret’s Syndrome as a Rare Life-Threatening Complication of Gallstone Disease—A Surgical Problem: Two Case Reports |
| title_sort | bouveret s syndrome as a rare life threatening complication of gallstone disease a surgical problem two case reports |
| topic | Bouveret’s syndrome gallstone ileus cholecystectomy surgical strategy duodeno-biliary fistula |
| url | https://www.mdpi.com/1648-9144/61/1/5 |
| work_keys_str_mv | AT nebojsasignjatovic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT ilijadgolubovic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT miodragndjordjevic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT markomstojanovic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT danielaabenedetostojanov bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT jelenasignjatovic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT jelenadzivadinovic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports AT sonjagolubovic bouveretssyndromeasararelifethreateningcomplicationofgallstonediseaseasurgicalproblemtwocasereports |