title: An unusual presentation of cholecystoduodenal fistula: vomiting of gallstones.
abstract: Bouveret's syndrome is defined as gastric outlet obstruction secondary to an impacted gallstone in the duodenum via a cholecystoduodenal or cholecystogastric fistula. Common radiological findings include pneumobilia, calcified right upper quadrant mass, pyloric or duodenal obstruction and cholecystoduodenal fistula. Initial attempts through endoscopic retrieval may be successful; however, results can vary. Surgical options include enterolithotomy or gastrotomy with or without cholecystectomy and fistula repair. We describe a unique case of Bouveret's syndrome with short-lived obstruction followed by vomiting of gallstones in a morbidly obese patient and discuss the complexities of investigation and management of these patients.
authors.affiliation: Department of General Surgery, James Cook University Hospital, Middlesbrough, UK. wendylthomson@gmail.com
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Thomson
authors.forename: Sumeet
authors.initials: S
authors.lastname: Miranda
authors.forename: Anil
authors.initials: A
authors.lastname: Reddy
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D042882:Gallstones; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014839:Vomiting / Q000209:etiology*