title: A possible variant of Bouveret's syndrome presenting as a duodenal stump obstruction by a gallstone after Roux-en-Y gastrectomy: a case report.
abstract: BACKGROUND
  Bouveret's syndrome is characterized by gastric outlet obstruction due to a gallstone in the duodenum, usually in association with a cholecystoduodenal fistula.
  
  
  METHODS
  We report the case of a 69-year-old Caucasian man who developed duodenal stump obstruction due to an impacted gallstone after having previously undergone Roux-en-Y gastrectomy.
  
  
  CONCLUSIONS
  Duodenal stump obstruction after Roux-en-Y gastrectomy is rare, and may be difficult to manage. Patients who present with upper gastrointestinal or pancreatobiliary pathology after previous gastric surgery should be managed in centres with the availability of appropriate endoscopic and surgical experience.
authors.affiliation: Department of Surgery, St Thomas' Hospital Lambeth Palace Road, London SE1 7EH UK.
authors.forename: Shruti
authors.initials: S
authors.lastname: Mittal
authors.forename: Robert P
authors.initials: RP
authors.lastname: Sutcliffe
authors.forename: Ashish
authors.initials: A
authors.lastname: Rohatgi
authors.forename: Simon W
authors.initials: SW
authors.lastname: Atkinson