Gastric Outlet Obstruction by a Large Gallstone (Bouveret’s Syndrome)

Abstract

Bouveret’s syndrome is an uncommon cause of gastric outlet obstruction due to intraluminal duodenal obstruction by a large gallstone, which has migrated via a cholecystoduodenal fistula. The presenting symptoms are not specific in the majority of cases, but most of the patients have known biliary lithiasis. Usually Bouveret’s syndrome carries a poor prognosis. Consideration of Bouveret’s syndrome in patients presenting with gastric outlet obstruction is important because of the rarity of this entity and the difference in the required surgical approach from that applied for other more common causes of obstruction. We present the case of a 55-year-old male with Bouveret’s syndrome, presenting as the first manifestation of gallstone disease, and successfully treated by open surgery, with a comprehensive literature review.