title: Bouveret's syndrome complicated by acute pancreatitis.
abstract: OBJECTIVE
  This study evaluated a case of Bouveret's syndrome due to a cholecystoduodenal fistula and gallstone obstruction of the duodenum, complicated by acute pancreatitis and cholecystitis.
  
  
  METHODS
  The presenting features, special investigations, radiological findings, operative and endoscopic procedures were reviewed.
  
  
  RESULTS
  Symptoms persisted after laparotomy and removal of a gallstone in the duodenum. Intra-operative endoscopy identified a second previously undetected stone impacted in the distal duodenum.
  
  
  CONCLUSIONS
  The importance of excluding more than one stone causing Bouveret's syndrome is emphasized.
authors.affiliation: Surgical Gastroenterology and Department of Surgery, University of Cape Town and Groote Schuur Hospital, South Africa.
authors.forename: R F
authors.initials: RF
authors.lastname: Fenchel
authors.forename: J E
authors.initials: JE
authors.lastname: Krige
authors.forename: P C
authors.initials: PC
authors.lastname: Bornman
mesh_terms: D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013577:Syndrome; D014057:Tomography, X-Ray Computed