López-Martínez José Antonio, Delgado-Carlo Mirna Magali, Palacio-Vélez Fernando, Arenas-Espino Gabriela, Granja-Posada Enrique, Senado-Lara Isaac, García-Alvarado Laureano
Servicio de Cirugía General, Hospital Regional General Ignacio Zaragoza, ISSSTE, México, DF.
Cir Cir. 2004 Jul-Aug;72(4):317-22.
Bouveret's syndrome is characterized by piloro-duodenal obstruction following the implant of a giant gallstone with gallstone ileus origin. It constitutes the less common variety of gallstone ileus (1-3%), mainly affecting elderly patients with chronic degenerative illnesses, possibly with high mortality.
We report the case of a patient with a less common variety of gallstone ileus. The patient was treated at a third-level care hospital.
Patient is a 52-year-old male with gastric obstruction and secondary dehydration. Studies were supported by a series of esophagus-gastric-duodenal and broad endoscopy. Piloro-duodenal obstruction by a giant gallstone was reported which could not be extracted by endoscopy. The patient was taken to surgery where a giant gallstone lying in the duodenal site was found and biliary vesicular scleroatrophic. Gastrotomy is effected with the extraction of the gallstone and gastrography. Gallstone duodenal fistula is then identified with support analysis.
Bouveret's syndrome is a rare entity whose diagnosis has a high sensitivity and specificity with a supported radiographic diagnosis. Endoscopy is difficult in the case of a giant impacted gallstone, making surgery the best therapeutic choice.
布韦雷氏综合征的特征是源于胆石性肠梗阻的巨大胆结石嵌顿后导致幽门十二指肠梗阻。它是胆石性肠梗阻中较罕见的类型（1%-3%），主要影响患有慢性退行性疾病的老年患者，死亡率可能较高。
我们报告一例罕见类型胆石性肠梗阻患者的病例。该患者在一家三级护理医院接受治疗。
患者为一名52岁男性，患有胃梗阻并继发脱水。通过一系列食管-胃-十二指肠检查及广泛的内镜检查辅助诊断。报告显示存在巨大胆结石导致的幽门十二指肠梗阻，内镜无法取出结石。患者接受手术，术中发现十二指肠部位有一枚巨大胆结石，胆囊呈硬化萎缩状。实施胃切开术取出胆结石并进行胃造影检查。随后通过辅助分析确定存在胆结石十二指肠瘘。
布韦雷氏综合征是一种罕见病症，其诊断在影像学诊断支持下具有较高的敏感性和特异性。对于巨大嵌顿性胆结石，内镜检查困难，手术是最佳治疗选择。
