title: Multiple giant duodenal gallstones causing gastric outlet obstruction: Bouveret's minefield revisited.
abstract: Gastric outlet obstruction caused by a gallstone impacted in the duodenum is a rare entity known as Bouveret's syndrome. We report the unusual case of multiple large gallstones impacted in the duodenum from a cholecystoduodenal fistula in an 83-year-old lady. A high index of suspicion allowed for prompt diagnosis. Early surgical intervention was instituted because if the size and number of gallstones with an excellent outcome. The surgical strategies and underlying pitfalls underlying the management of this syndrome are critically reviewed and discussed.
authors.affiliation: Department of Surgery, Singapore General Hospital, Singapore 169608. gsutym@sgh.gov.sg
authors.forename: Y M
authors.initials: YM
authors.lastname: Tan
authors.forename: A W
authors.initials: AW
authors.lastname: Yeo
authors.forename: C Y
authors.initials: CY
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery*; D017219:Gastric Outlet Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D036542:Tomography, Spiral Computed