First case reported of Bouveret´s syndrome associated to duodenal and biliary perforation to retroperitoneum.
We present the case of a 69 year old woman with a history of cholecystitis, who consulted for severe abdominal pain, nausea and vomiting. Abdominal CT showed duodenal obstruction caused by a gallstone, cholecystoduodenal fistula and pneumobilia, what is known as Bouveret's syndrome, a rare form of gallstone ileus. Additionally, she presented free duodenal and vesicular perforation to retroperitoneum at the same level of the cholecystoduodenal transit point. The patient underwent a difficult cholecystectomy, enterolithotomy, repair of the duodenal defect, extensive washing and drainage of the retroperitoneum. The postoperative course was uneventful except for a laparotomy infection.
Cirugía General, Hospital 12 de Octubre, España.
María Victoria
MV
Vieiro Medina
Hospital Universitario 12 de Octubre.
Ramón
R
Gómez Sanz
Hospital Universitario 12 de Octubre.
Eneida
E
Bra Insa
Hospital Universitario 12 de Octubre.
Iván
I
Domínguez Sánchez
Hospital Universitario 12 de Octubre.
Marta
M
de la Fuente Bartolomé
Hospital Universitario 12 de Octubre.
David
D
Díaz Pérez
Hospital Universitario 12 de Octubre.
Oana
O
Anisa Nutu
Hospital Universitario 12 de Octubre.
Felipe
F
de la Cruz Vigo
D000368:Aged; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002763:Cholecystectomy; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017219:Gastric Outlet Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging / Q000601:surgery; D013577:Syndrome; D014057:Tomography, X-Ray Computed