Alsolaiman Mohammad M, Reitz Christoph, Nawras Ali T, Rodgers John B, Maliakkal Benedict J
Division of Gastroenterology, Department of Medicine, Albany Medical College and VA Stratton Hospital, Albany, New York, USA.
BMC Gastroenterol. 2002 Jun 18;2:15. doi: 10.1186/1471-230x-2-15.
Bouveret's syndrome is an unusual presentation of duodenal obstruction caused by the passage of a large gallstone through a cholecystoduodenal fistula. Endoscopic therapy has been used as first-line treatment, especially in patients with high surgical risk.
We report a 67-year-old woman who underwent an endoscopic attempt to fragment and retrieve a duodenal stone using a Holmium: Yttrium-Aluminum-Garnet Laser (Ho:YAG) which resulted in small bowel obstruction. The patient successfully underwent enterolithotomy without cholecystectomy or closure of the fistula.
We conclude that, distal gallstone obstruction, due to migration of partially fragmented stones, can occur as a possible complication of laser lithotripsy treatment of Bouveret's syndrome and might require urgent enterolithotomy.
布韦雷氏综合征是十二指肠梗阻的一种罕见表现，由大的胆结石通过胆囊十二指肠瘘管所致。内镜治疗已被用作一线治疗方法，尤其是对于手术风险高的患者。
我们报告一名67岁女性，她接受了使用钬：钇铝石榴石激光（Ho:YAG）对十二指肠结石进行内镜下碎石及取出的尝试，但导致了小肠梗阻。该患者成功接受了肠石切除术，未进行胆囊切除术或瘘管闭合术。
我们得出结论，由于部分破碎结石的迁移导致的远端胆结石梗阻，可能是布韦雷氏综合征激光碎石治疗的一种并发症，可能需要紧急进行肠石切除术。
