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gallstone ileus; Bouveret's syndrome

also see ileus Pathology: Bouveret's syndrome - gastric outlet obstruction - gallstone impaction in the pylorus or proximal duodenum after passage through a cholecystoduodenal fistula Clinical manifestations: - biliary colic case report Bouveret's syndrome - nausea/vomiting - right-upper-quadrant abdominal pain - abdominal distension - decreased bowel sounds - mild epigastric tenderness Radiology: - abdominal CT (image) [1] - Rigler's triad - pneumobilia (air in biliary tract) - small-bowel obstruction - ectopic gallstone Management: - lithotripsy with endoscopic removal of stone - laparotomy for repair & removal of stone

Related

cholelithiasis (gallstones)

General

ileus

References

  1. Ramos GP, Chiang NE Bouveret's Syndrome. N Engl J Med 2018; 378:1335 PMID: 29617586 http://www.nejm.org/doi/full/10.1056/NEJMicm1711592