The natural progression of a fistulizing gallstone resulting in massive gastrointestinal hemorrhage and Bouveret syndrome, a rare case

Elmer Hoekstra,Roeland Andreas Veenendaal,Rogier Stuyt,Maarten Willem Van Den Berg

doi:10.1007/s12328-019-01054-x

Elmer Hoekstra, Roeland Andreas Veenendaal + Show 2 more

Open Access

https://doi.org/10.1007/s12328-019-01054-x

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Abstract

Gallstones are seen very common, especially in the Western World. While most patients are asymptomatic, gallstones can cause life-threatening complications. Here, we present a rare and nearly fatal complication of gallstones, showing the natural progression of gallstone disease. With two very unusual complications of gallstones which occurred in the same patient. Massive gastrointestinal bleeding, and the Bouveret syndrome.

Highlights

In the Western world up to 15% of the adults have gallstones
Biliodigestive fistula are a rare complication of gallstone disease, with reported incidence rates of 3–5% in patients with cholelithiasis [1]
Gastrointestinal obstruction is rare, since most of the gallstones can pass through the GI-tract spontaneously

Summary

Introduction

In the Western world up to 15% of the adults have gallstones. While most of them remain asymptomatic, gallstones can result in several complaints with the biliary colic as the most prevalent. Other complications such as symptomatic cholecystolithiasis, cholecystitis, cholangitis, and biliary pancreatitis is a quite common problem. More rare complications include gallstones fistuling towards the duodenum, with the possibility of causing a gastrointestinal obstruction. We present a rare and nearly fatal complication of gallstones, showing the natural progression of gallstone disease

Case report

Findings

Discussion