title: Choleduodenal fistula with gastric outlet obstruction.
abstract: Bouveret's syndrome, cholecystoduodenal fistula with gastric outlet obstruction secondary to an impacted gallstone, is a rare but serious complication of cholelithiasis. We report the case of a 69-year-old woman who presented with epigastric pain and vomiting in whom cross-sectional imaging revealed a duodenal mass with cholecystoduodenal fistula and pneumobilia. Endoscopic evaluation identified a large gallstone obstructing the pyloric channel. She underwent laparotomy and stone extraction with pyloroplasty, had an unremarkable recovery. She was asymptomatic at 15 months follow-up.
authors.affiliation: Department of HPB Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Dong
authors.affiliation: Department of HPB Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Alfredo Daniel
authors.initials: AD
authors.lastname: Guerron
authors.affiliation: Department of HPB Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Gareth
authors.initials: G
authors.lastname: Morris-Stiff
authors.affiliation: Department of HPB Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Sricharan
authors.initials: S
authors.lastname: Chalikonda
mesh_terms: D000368:Aged; D004380:Duodenal Obstruction / Q000209:etiology*; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000000981:diagnostic imaging; D017219:Gastric Outlet Obstruction / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D007813:Laparotomy; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000209:etiology