title: Obstruction of the duodenal bulb caused by gallstone perforation.
abstract: Because of acute symptoms in the upper abdomen, upper gastrointestinal endoscopy was performed in a 75-year-old female patient. A large (5 cm x 10 cm) perforated gallstone was embedded in the duodenum, causing complete obstruction of the duodenal bulb. The stone was removed via pylorotomy. A fistula remained between the gallbladder and the duodenum. Cholecystectomy was not carried out because of the unfavourable cardiac condition of the patients. There was no complications.
mesh_terms: D000368:Aged; D002769:Cholelithiasis / Q000150:complications*; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology*; D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis; D007416:Intestinal Perforation / Q000209:etiology*