Gastrointestinal Surgery, Army Hospital (Research and Referral), New Delhi, Delhi, India.
Gastrointestinal Surgery, Command Hospital (Western Command), Panchkula, Haryana, India.
BMJ Case Rep. 2024 Jun 18;17(6):e261232. doi: 10.1136/bcr-2024-261232.
Bouveret's syndrome is an uncommon cause of gastric outlet obstruction caused by the impaction of large gallstones in the duodenal lumen. The gallstones pass into the duodenal lumen through a cholecystogastric or a cholecystoduodenal fistula. Endoscopic retrieval with or without lithotripsy is the first line of management, often with variable success. We present a case of a woman in her 70s who presented with signs of gastric outlet obstruction and was diagnosed with Bouveret's syndrome with a 5 cm diameter gallstone in the third part of her duodenum. Following several unsuccessful attempts of endoscopic extraction, she underwent successful jejunal enterotomy with fragmentation and extraction of the calculus using an Allis tissue holding forceps. Postoperative recovery was uneventful.
Bouveret 综合征是一种不常见的胃出口梗阻病因，由较大的胆结石嵌顿于十二指肠腔内引起。这些胆结石通过胆囊-胃或胆囊-十二指肠瘘进入十二指肠腔。内镜下取石术联合或不联合碎石术是一线治疗方法，但成功率不一。我们报告了一例 70 多岁的女性，因胃出口梗阻的症状就诊，诊断为 Bouveret 综合征，其十二指肠第三段有一 5cm 直径的胆结石。尽管进行了多次内镜取石尝试，但均未成功，随后行空肠切开术，使用 Allis 组织夹持镊碎裂并取出结石。术后恢复顺利。
