Bouveret syndrome.: Report of four cases
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Date
2008
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Abstract
Background: Bouveret sYndrome is a duodenal obstruction caused by a biliary stone, Aim: To report patients with Bouveret syndrome. Material and Methods: Retrospective review of medical records of patients with Bouveret syndrome treated between. 1976 and 2006. Results. We report three women and one man with a mean age of 62.5 years. None bad a previous diagnosis of cholelithiasis. All presented with colicky pain in the right upper quadrant and vomiting, suggesting gastric retention. The diagnosis was suspected after a barium meal in two patients and with a CT scan or. the other two. Tbe endoscopical extraction or fragmentation of stones was attempted in three patients but was succesful only in one. Three patients were operated and a stone impacted in the first portion of the duodenum was identified, along with a cholecystodudenal fistula. A duodenostomy and stone extraction was performed. One patient was subjected to a cholecystectomy, fistula repair and gastrojejunoanastomosis. No patient died and all were discharged within. 8 to 12 days after surgery. Conclusions: Bouveret sYndrome is an uncommon complication of cholelithiasis. Endoscopy can be diagnostic and therapeutic. Surgery is the other therapeutic option.
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Keywords
duodenostomy, duodenal obstruction, gallstones