Enumah Zachary Obinna, Wong Evan G, Kent Alistair J
Johns Hopkins University School of Medicine, Department of Surgery, Baltimore, MD, USA.
McGill University, Department of Surgery, Montreal, Canada.
Int J Surg Case Rep. 2020;77:96-99. doi: 10.1016/j.ijscr.2020.10.076. Epub 2020 Oct 22.
Bouveret Syndrome is a rare but important variant of gallstone ileus with high potential for morbidity and mortality. Bouveret syndrome is a complication of gallstone disease resulting from chronic inflammation and subsequent fistulization between the gallbladder and duodenum or stomach with subsequent impaction of the stone in the proximal GI tract. Here we present a case in an elderly man with moderate medical comorbidities.
An elderly man presented to the hospital with symptoms of gastrointestinal obstruction. Upon further diagnostic work-up, he was noted to have a 5.8 cm gallstone impacted in his proximal GI tract and thus diagnosed with a rare variant of gallstone ileus-Bouveret syndrome.
The therapeutic goal in approaching Bouveret syndrome is removal of the stone and improvement in obstruction and cholangitis. This may be accomplished with surgery or endoscopic therapy-although this may be less effective. Bouveret syndrome may have high morbidity.
Bouveret syndrome is a rare but potentially serious syndrome that should be managed accordingly. It should remain on the differential diagnosis of an elderly patient presenting with gastrointestinal obstructions, particularly if there is a history of gallstone disease and concern for proximal GI obstruction.
布维雷综合征是胆石性肠梗阻的一种罕见但重要的变异型，具有较高的发病和死亡风险。布维雷综合征是胆石症的一种并发症，由慢性炎症以及随后胆囊与十二指肠或胃之间形成瘘管，进而导致结石在近端胃肠道嵌顿引起。在此，我们报告一例患有中度内科合并症的老年男性病例。
一名老年男性因胃肠道梗阻症状入院。经过进一步的诊断检查，发现他的近端胃肠道有一枚5.8厘米的胆结石嵌顿，因此被诊断为胆石性肠梗阻的罕见变异型——布维雷综合征。
治疗布维雷综合征的目标是取出结石并改善梗阻和胆管炎情况。这可以通过手术或内镜治疗来实现——尽管内镜治疗可能效果较差。布维雷综合征可能具有较高的发病率。
布维雷综合征是一种罕见但可能严重的综合征，应予以相应处理。对于出现胃肠道梗阻的老年患者，尤其是有胆石症病史且怀疑近端胃肠道梗阻的患者，应将其列入鉴别诊断范围。
