A typical presentation of a rare complication of cholelithiasis: Bouveret syndrome

Abstract

Bouveret syndrome (BS) is an exceptionally rare variant of gallstone ileus, specified by gastric outlet obstruction resulting from migration of a large gallstone through the bilio-enteric fistula and is impacted in the pylorus or duodenum. We present an atypical case of BS. A 60-year old male came in Era’s Lucknow medical college who had undergone multiple diagnostic procedures (x-ray kidney ureter bladder, ultrasonography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopy) (MRCP) for his unusual presentation of right lower abdominal pain without any signs or symptoms of gastric outlet obstruction (nausea or vomiting). Initial attempts of endoscopic retrieval of stone with extracorporeal lithotripsy were performed as first-line treatment which had failed, therefore a successful surgical extraction of stone by enterolithotomy was attempted without cholecystectomy.