An unusual presentation of cholecystoduodenal fistula: vomiting of gallstones

Bouveret's syndrome is defined as gastric outlet obstruction secondary to an impacted gallstone in the duodenum via a cholecystoduodenal or cholecystogastric fistula. Common radiological findings include pneumobilia, calcified right upper quadrant mass, pyloric or duodenal obstruction and chole...

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Bibliographic Details
Published in:BMJ case reports 2012-11, Vol.2012, p.bcr2012007009
Main Authors: Thomson, Wendy L, Miranda, Sumeet, Reddy, Anil
Format: Article
Language:English
Subjects:
Abdomen
Diagnosis, Differential
Endoscopy
Family medical history
Female
Gallstones
Gastric Outlet Obstruction - diagnosis
Gastric Outlet Obstruction - etiology
Humans
Intestinal Fistula - diagnosis
Middle Aged
Obesity
Obesity, Morbid - complications
Pain
Tomography, X-Ray Computed
Ultrasonic imaging
Ultrasonography
United Kingdom
Unusual Presentation of More Common Disease/Injury
Vomiting - etiology
Weight control
White
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Description
Summary:Bouveret's syndrome is defined as gastric outlet obstruction secondary to an impacted gallstone in the duodenum via a cholecystoduodenal or cholecystogastric fistula. Common radiological findings include pneumobilia, calcified right upper quadrant mass, pyloric or duodenal obstruction and cholecystoduodenal fistula. Initial attempts through endoscopic retrieval may be successful; however, results can vary. Surgical options include enterolithotomy or gastrotomy with or without cholecystectomy and fistula repair. We describe a unique case of Bouveret's syndrome with short-lived obstruction followed by vomiting of gallstones in a morbidly obese patient and discuss the complexities of investigation and management of these patients.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2012-007009