Kalwaniya Dheer Singh, Arya S V, Guha Soumya, Kuppuswamy Manigandan, Chaggar Jasneet G, Ralte Lalmalsamwe, Chejera Rajkumar, Sharma Ashok
Dept. of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India.
Ann Med Surg (Lond). 2015 Feb 16;4(1):67-71. doi: 10.1016/j.amsu.2015.02.001. eCollection 2015 Mar.
Bouveret's Syndrome is a rare cause of Gastric outlet obstruction (GOO) caused by a gall stone which has migrated into the duodenal bulb from a bilioduodenal fistula. It is an uncommon condition and only a few cases have been reported in the medical literature till to date.
We report a case of a 45 year old woman who presented to us with recurrent pain in the upper abdomen for the last 8 years, and that progressed to develop symptoms of gastric outlet obstruction. An upper gastrointestinal endoscopy revealed duodenal ulceration with a stony hard lesion in the first part of duodenum. An contrast enhanced computed tomography (CECT) scan of the abdomen performed later confirmed the presence of cholecystoduodenal fistula and a gall-stone in proximal jejunum.
Bouveret's syndrome is a case of gastric outlet obstruction caused by the impaction of a large gall stone in the duodenum as a result of a cholecystoduodenal fistula. It constitutes 1-3% of cases of gall stone ileus which in turn complicates only 0.3-4% cases of cholelithisasis. Bouveret's syndrome is managed surgically.
Bouveret's syndrome being an uncommon condition may pose a difficulty in diagnosis and dilemma in managing such patients. An awareness is hence essential.
布韦雷氏综合征是胃出口梗阻（GOO）的一种罕见病因，由胆结石经胆十二指肠瘘移入十二指肠球部所致。这是一种不常见的病症，迄今为止医学文献中仅报道了少数病例。
我们报告一例45岁女性患者，她在过去8年中反复出现上腹部疼痛，并逐渐发展为胃出口梗阻症状。上消化道内镜检查显示十二指肠溃疡，十二指肠第一部有一个坚硬如石的病变。随后进行的腹部增强计算机断层扫描（CECT）证实存在胆囊十二指肠瘘和空肠近端的胆结石。
布韦雷氏综合征是由于胆囊十二指肠瘘导致大的胆结石嵌顿在十二指肠而引起的胃出口梗阻病例。它占胆结石性肠梗阻病例的1 - 3%，而胆结石性肠梗阻仅占胆石症病例的0.3 - 4%。布韦雷氏综合征通过手术治疗。
布韦雷氏综合征作为一种不常见的病症，在诊断上可能存在困难，在治疗此类患者时也会面临困境。因此，提高认识至关重要。
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