Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 4144-4149
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4144
Bouveret syndrome: A case report
Fei Wang, Zhi-Qiang Du, Yi-Lan Chen, Tian-Ming Chen, Yue Wang, Xiang-Rong Zhou
Fei Wang, Zhi-Qiang Du, Yi-Lan Chen, Tian-Ming Chen, Yue Wang, Xiang-Rong Zhou, Department of Gastroenterology, People’s Hospital of Jianyang City, Jianyang 641400, Sichuan Province, China
Author contributions: Wang F and Du ZQ provided the concept for the study; Wang F drafted the manuscript; Zhou XR, Tian-Ming Chen, and Du ZQ performed the review; Wang Y and Chen YL provided the images; all authors have read and approved the content of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Qiang Du, MD, Chief Doctor, Department of Gastroenterology, People’s Hospital of Jianyang City, No. 180, Hospital Road, Jianyang 641400, Sichuan Province, China. 1028606063@qq.com
Telephone: +86-13730738579 Fax: +86-282-7237980
Received: August 19, 2019
Peer-review started: August 19, 2019
First decision: September 10, 2019
Revised: September 24, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: December 6, 2019
Processing time: 106 Days and 7.9 Hours
Abstract
BACKGROUND

Bouveret syndrome is a rare complication of cholelithiasis, with only 315 cases reported in the literature between 1967 and 2016. Delay in diagnosis is associated with a high mortality rate. Diagnosis is based upon clinical manifestations, gastroscopy, and imaging studies such as abdominal computed tomography and magnetic resonance cholan-giopancreatography. Endoscopic stone extraction or lithotripsy is the preferred choice for treatment as it is safe and minimally invasive with few complications. However, if endoscopy fails, surgery is required.

CASE SUMMARY

A 61-year-old female patient presented with recurrent epigastric pain for more than 6 mo. On endoscopy, a large amount of food residue was present in the stomach with multiple stones and ulcers in the antro-pyloric region. Based on these findings, a diagnosis of gastrolithiasis was made. However, computed tomography of the abdomen revealed the correct diagnosis of Bouveret syndrome. Initially, endoscopic treatment was attempted but it failed. Later, she was successfully managed by cholecystectomy with duodenal stone extraction and fistula repair (one-step method). At the last follow-up 6 mo after surgery, the patient was symptom-free.

CONCLUSION

Bouveret syndrome is a rare complication of gallstones that requires prompt endoscopic or surgical treatment to prevent mortality.

Keywords: Bouveret syndrome; Gallstones; Intestinal obstruction; Case report

Core tip: Bouveret syndrome is a rare clinical disease, with only 315 cases reported in the literature between 1967 and 2016. The disease is often misdiagnosed and has high mortality if diagnosis is delayed. Here, we describe a case of Bouveret syndrome, which was initially misdiagnosed as gastric calculus based on endoscopy but was later correctly diagnosed with Bouveret syndrome on computed tomography. The patient was successfully treated by surgery after failed endoscopic therapy.