I am a
Home I AM A Search Login

Papers of the Week

2019 Aug

ACG Case Rep J



Bouveret Syndrome: When a Stone Cannot Pass the Pylorus.


Khuwaja S, Azeem A, Semkhayev BA, Afthinos J, Guttmann S
ACG Case Rep J. 2019 Aug; 6(8):e00176.
PMID: 31737712.


Bouveret syndrome, a rare cause of intestinal obstruction, occurs by passage of a gallstone through a cholecystoduodenal fistula into the intestinal lumen. Presenting symptoms are nausea, vomiting, and abdominal pain. In some cases, chronic symptoms result in weight loss. Typically, the syndrome is diagnosed via x-ray, ultrasound, or computed tomography. Treatment options are endoscopic or surgical. Endoscopic approaches include mechanical lithotripsy, electrohydraulic lithotripsy, stone extraction, laser lithotripsy, extracorporeal shockwave lithotripsy, and/or duodenal stenting. When stone fragments migrate distally, surgical removal becomes necessary. We describe a distinct endoscopic treatment via stone breakage, followed by pushing the fragments of the stone into the jejunum, resolving the intestinal obstruction.