A rare variant of gallstone ileus: Bouveret's syndrome.
BACKGROUND
Bouveret's syndrome (gastric outlet obstruction due to impaction of a stone) is a rare variant of gallstone ileus. A recently observed case led us to review the literature, with the aim to discuss the recent advances in the management of this rare syndrome.


CONCLUSIONS
A 69-year-old woman was admitted with symptoms of high intestinal obstruction. Computed tomography scan of the abdomen showed a large gallstone impacted in the duodenum. One-stage surgery, consisting in enterolithotomy, cholecystectomy, and fistula repair, was carried out. Although several surgical and nonoperative procedures have been used, the optimal treatment of Bouveret's syndrome remains controversial. Surgery still maintains a prominent position, even though nonoperative procedures have an increasing role especially in high risk patients with important comorbidities. The decision should be taken on an individual basis, after evaluating patient's general condition and age, stone size, comorbidities influencing the operative risk, and expertise of surgical and endoscopic teams. One-stage surgery may offer definitive management in selected patients.
Fancellu
Alessandro
A
Department of Surgery, Institute of Clinica Chirurgica, University of Sassari, Vle San Pietro 43, 07100 Sassari, Italy. afancel@uniss.it
Niolu
Pietro
P
Scanu
Antonio M
AM
Feo
Claudio F
CF
Ginesu
Giorgio C
GC
Barmina
Maria L
ML
D000368:Aged; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D013577:Syndrome; D014057:Tomography, X-Ray Computed