Ibrahim Mohamed, El-Husari Ali, Tabbaa Hozaifa, Herman Michael
College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Gastroenterology, Borland Groover, Jacksonville, USA.
Cureus. 2023 Jun 5;15(6):e40005. doi: 10.7759/cureus.40005. eCollection 2023 Jun.
Bouveret syndrome (BS) is a rare but serious complication of gallstone ileus that can cause gastric outlet obstruction secondary to a gallstone impacted in the pylorus or proximal duodenum. Gallstones pass from the gallbladder to the GI tract via a cholecystoenteric fistula that forms as a result of chronic inflammation and adhesions between the biliary system and GI tract. Although the case we are presenting is of a 53-year-old Hispanic male, females and the elderly are particularly at an increased risk of this condition. BS can present as typical mechanical obstruction symptoms that include nausea, vomiting, and diffuse abdominal pain. The vague symptoms patients present with makes the diagnosis difficult and often delayed, which can be fatal. In our case, the diagnosis of BS was supported by a CT with contrast, MRI, and an esophagogastroduodenoscopy (EGD) study. Our patient underwent an exploratory laparotomy after the diagnosis was made, and the stone was removed. Here, we aim to raise awareness of the importance of early recognition, and immediate action in establishing an early diagnosis of BS in patients presenting with nonspecific abdominal symptoms, which can prevent mortalities.
布韦里综合征（BS）是胆石性肠梗阻一种罕见但严重的并发症，可导致因胆结石嵌顿于幽门或十二指肠近端而继发胃出口梗阻。胆结石通过胆囊肠瘘从胆囊进入胃肠道，该瘘是由于胆道系统与胃肠道之间的慢性炎症和粘连形成的。虽然我们报道的病例是一名53岁的西班牙裔男性，但女性和老年人尤其更容易患这种疾病。BS可表现为典型的机械性梗阻症状，包括恶心、呕吐和弥漫性腹痛。患者出现的症状不明确，使得诊断困难且常常延误，这可能是致命的。在我们的病例中，对比增强CT、MRI和食管胃十二指肠镜检查（EGD）支持了BS的诊断。确诊后，我们的患者接受了剖腹探查术，并取出了结石。在此，我们旨在提高人们对早期识别的重要性的认识，并在对出现非特异性腹部症状的患者进行BS早期诊断时立即采取行动，这可以预防死亡。
