Bouveret's syndrome: should we remove the gall bladder?
Bouveret's syndrome is a rare cause of intestinal obstruction caused by gallstones and is usually seen in older patients with poor medical status. The surgical treatment for these patients is controversial. The authors present a case of a 73-year-old woman who presented with coffee ground vomiting. An upper gastrointestinal endoscopy showed a big gallstone obstructing the duodenal bulb and a CT scan showed a cholecystoduodenal fistula. The stone could not be removed or crushed endoscopically and a laparotomy was undertaken to relieve the obstruction. The stone was removed by gastrotomy and a delayed cholecystectomy was not offered due to her co-morbid conditions. She presented 18 months later with pancreatitis and has now been offered an elective cholecystectomy.
Department of General Surgery, Barnsley District Hospital NHS Foundation Trust, Barnsley, UK. sjafferbhoy@doctors.org.uk
Sadaf
S
Jafferbhoy
Quatullah
Q
Rustum
Mohammed
M
Shiwani
D000368:Aged; D002763:Cholecystectomy; D004378:Duodenal Diseases / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D013577:Syndrome