title: "Bouveret's syndrome" presenting with acute pancreatitis a very rare and challenging variant of gallstone ileus.
abstract: BACKGROUND
  Bouveret's syndrome is a rare variant of gallstone ileus and describes gastric outlet obstruction secondary to an impacted stone in the duodenum. Its presentation is vague and clinical diagnosis is often difficult resulting in a delay in diagnosis.
  
  
  METHODS
  We report a patient who presented initially with non-specific symptoms and subsequently with features in keeping with acute pancreatitis, but eventually was found to have Bouveret's syndrome.
  
  
  CONCLUSIONS
  Different treatment strategies are discussed. Although endoscopic treatment combined with many newer modalities like lithotripsy have been tried, surgery remains the definitive management in the vast majority of cases.
  
  
  CONCLUSIONS
  Bouveret's syndrome is a rare condition, can also present as pancreatitis and often difficult to diagnose initially, but with appropriate treatment has a good outcome.
authors.affiliation: Department of General & Upper Gastrointestinal Surgery, Dewsbury & District Hospital, The Mid Yorkshire Hospitals NHS Trust, Halifax Road, Dewsbury, West Yorkshire WF13 4HS, United Kingdom. Electronic address: hawkeye_wolf@hotmail.com.
authors.forename: Arif
authors.initials: A
authors.lastname: Zafar
authors.forename: Gemma
authors.initials: G
authors.lastname: Ingham
authors.forename: Jainudeen K A
authors.initials: JK
authors.lastname: Jameel