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J Visc Surg. 2012 Aug;149(4):e284-6. doi: 10.1016/j.jviscsurg.2012.02.001. Epub 2012 May 23.

Bouveret's syndrome. An unusual localization of gallstone ileus.

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  • 1Département des maladies de l'appareil digestif, groupe hospitalier Paris-Saint-Joseph, 185, rue R.-Losserand, 75014 Paris, France.


This case report describes a 77-year-old male, who presented to the emergency room with symptoms of an acute proximal small bowel obstruction. Abdominal CT scan with multi-planar reconstructions led to the diagnosis of an intestinal obstruction due to impaction of a large gallstone in the second portion of the duodenum. The CT scan demonstrated a large cholecysto-duodenal fistula as the origin of the gallstone migration. Surgical treatment consisted of milking the stone down beyond the ligament of Treitz, where it was removed through a jejunal enterotomy. The postoperative course was uncomplicated. No attempt was made to repair the choledocho-duodenal fistula at the initial intervention nor subsequently, and there have been no complications due to the fistula over 36 months of follow-up observation.

Copyright © 2012. Published by Elsevier Masson SAS.

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