Bouveret's Syndrome: A rare cause of gastric outlet obstruction

Abstract

Bouveret's Syndrome is a rare cause of gastric outlet obstruction secondary to the impaction of a gallstone within a cholecystogastric or cholecystoduodenal fistula. It is a rare variant of gallstone ileus. Prompt diagnosis, appropriate investigations and proper treatment are essential. The aim of the present case report was to review the currently‐available literature regarding Bouveret's syndrome management approach and to share our experience. A 69‐year‐old man presented to our surgical unit with a 1‐week history of upper gastrointestinal bleeding and gastric outlet obstruction symptoms. The diagnosis of Bouveret's Syndrome was confirmed with computed tomography. He subsequently underwent a one‐stage open partial gastrectomy and cholecystectomy with Roux‐en‐Y anastomosis and controlled duodenostomy. Postoperative recovery was uneventful and the patient was discharged on postoperative day 11. With the current paucity of high‐level evidence regarding the management approach for Bouveret's syndrome, the gold standard management algorithm is yet to be developed. The management approach should be tailored, with an appropriate choice of treatment based on the patient's clinical presentation and comorbidities and the expertise available. Surgical approach should be considered if endoscopic treatment is not feasible or has failed.