[Bouveret's syndrome. Case report].
BACKGROUND
Bouveret's syndrome is characterized by piloro-duodenal obstruction following the implant of a giant gallstone with gallstone ileus origin. It constitutes the less common variety of gallstone ileus (1-3%), mainly affecting elderly patients with chronic degenerative illnesses, possibly with high mortality.


OBJECTIVE
We report the case of a patient with a less common variety of gallstone ileus. The patient was treated at a third-level care hospital.


METHODS
Patient is a 52-year-old male with gastric obstruction and secondary dehydration. Studies were supported by a series of esophagus-gastric-duodenal and broad endoscopy. Piloro-duodenal obstruction by a giant gallstone was reported which could not be extracted by endoscopy. The patient was taken to surgery where a giant gallstone lying in the duodenal site was found and biliary vesicular scleroatrophic. Gastrotomy is effected with the extraction of the gallstone and gastrography. Gallstone duodenal fistula is then identified with support analysis.


CONCLUSIONS
Bouveret's syndrome is a rare entity whose diagnosis has a high sensitivity and specificity with a supported radiographic diagnosis. Endoscopy is difficult in the case of a giant impacted gallstone, making surgery the best therapeutic choice.
Servicio de Cirugía General, Hospital Regional General Ignacio Zaragoza, ISSSTE, México, DF.
José Antonio
JA
López-Martínez
Mirna Magali
MM
Delgado-Carlo
Fernando
F
Palacio-Vélez
Gabriela
G
Arenas-Espino
Enrique
E
Granja-Posada
Isaac
I
Senado-Lara
Laureano
L
García-Alvarado
D004380:Duodenal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011708:Pylorus; D013577:Syndrome