title: Laparoscopic treatment of an upper gastrointestinal obstruction due to Bouveret's syndrome.
abstract: Bouveret's syndrome is an extremely rare type of gallstone-induced ileus with atypical clinical manifestations, such as abdominal distension and pain, nausea and vomiting, fever or even gastrointestinal bleeding, which may easily be misdiagnosed. In the present case, a 55-year-old male was admitted to the hospital with upper gastrointestinal obstructive symptoms but without pain, fever, jaundice or melena. At first, gastrolithiasis and peptic ulcer combined with pyloric obstruction were suspected after gastroscopy revealed a large, hard stone in the duodenal bulb. A revised diagnosis of Bouveret's syndrome was made following abdominal computed tomography. Subsequently, the patient exhibited a good postoperative recovery after laparoscopic duodenotomy for gallstone removal and subtotal cholecystectomy. The condition of the patient remained stable after being followed up for 6 mo. The successful application of laparoscopic therapy to treat Bouveret's syndrome has seldom been reported. Laparoscopic enterolithotomy is safe and effective, with good patient tolerability, rapid postoperative recovery and few wound-related complications. The laparoscopic treatment of Bouveret's syndrome is worth exploring.
authors.affiliation: Dong Yang, Zhi-Jun Duan, Department of Digestion, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yang
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Duan
authors.forename: Shi
authors.initials: S
authors.lastname: Jin
mesh_terms: D001658:Biliary Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D042882:Gallstones / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000601:surgery; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Bouveret’s syndrome; Cholecystoenteric fistula; Gallstone; Gastric outlet obstruction; Laparoscopic therapy