Duodenal stent insertion as palliative treatment for Bouveret's syndrome

Abstract

Bouveret’s syndrome is a rare condition characterized by gastric outlet obstruction secondary to impacted gallstone in the duodenal bulb. It occurs most commonly in elderly women who are often in poor general condition and at high surgical and mortal risk. Relief of the acute gastric obstruction is of primary importance. Endoscopic treatment with stone extraction, extracorporeal shockwave lithotripsy, intracorporeal electrohydraulic lithotripsy and endoscopic laser lithotripsy have all been described as alternatives to surgery. We present a case where the patient’s poor clinical state precluded a surgical procedure and palliative treatment in the form of fluoroscopic duodenal stent insertion was carried out, with good result.