Báez-García J J, Martínez-Hernández-Magro P, Iriarte-Gállego G
Departamento de Cirugía, Gastrointestinal del Hospital Guadalupano de Celaya, Celaya Gto., Mexico.
Rev Gastroenterol Mex. 2009 Apr-Jun;74(2):118-21.
To present a rare case of duodenal obstruction caused by an impacted gallstone(Bouveret s syndrome) and discusses the best therapeutic option for its resolution.
Bouveret's syndrome is the less common presentation of a gallstone ileus. This syndrome is rare and predominates in elderly women; the main symptoms are nausea, vomiting, and epigastric pain, and sometimes hematoemesis, mimicking a pyloric stenosis. Diagnosis is made by endoscopy. Endoscopic lithotripsy must be the first-line treatment however surgery is indicated in case of failure or complication during the procedure. Morbidity and mortality rates are high.
We present a 75 years old, female patient, with history of diabetes mellitus and hypertension. With 15 days of nausea, vomiting,loss of appetite and abdominal pain, with secondary dehydration and bad general conditions. She was subjected to an endoscopy and a duodenal obstruction by a large gallstone was founded,the endoscopic attempts to extract the gallstone were unsuccessful and surgery was performed with a dudenotomy and two layer closure with good outcome. The patient was discharged on the 8th postoperative day.
Bouveret's syndrome is a rare variety of a gallstone ileus and must be considered like differential diagnosis in cases of gastric outlet obstruction.
报告一例由嵌顿性胆结石引起的十二指肠梗阻（布韦雷综合征）罕见病例，并探讨解决该问题的最佳治疗方案。
布韦雷综合征是胆石性肠梗阻较少见的表现形式。该综合征罕见，以老年女性为主；主要症状为恶心、呕吐和上腹部疼痛，有时伴有呕血，类似幽门狭窄。通过内镜检查进行诊断。内镜碎石术必须作为一线治疗方法，然而，如果在手术过程中失败或出现并发症，则需进行手术治疗。其发病率和死亡率较高。
我们介绍一位75岁的女性患者，有糖尿病和高血压病史。患者出现恶心、呕吐、食欲不振和腹痛15天，继发脱水且全身状况较差。她接受了内镜检查，发现有一枚大的胆结石导致十二指肠梗阻，内镜取石尝试未成功，遂进行十二指肠切开术及两层缝合手术，效果良好。患者术后第8天出院。
布韦雷综合征是胆石性肠梗阻的一种罕见类型，在胃出口梗阻病例中必须考虑作为鉴别诊断。
