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老年患者布韦雷氏综合征的内镜治疗:一例报告

Endoscopic Management of Bouveret's Syndrome in an Elderly Patient: A Case Report.

作者信息

Zhang Meng, Sun Ya-Nan, Gao Feng, Sun Yong, Jia Wen, Huo Jian-Feng, Gu Jiang-Ning, Yang Zhuo

机构信息

Department of Digestive Endoscopy General Hospital of Northern Theater Command Shenyang Liaoning Province China.

出版信息

JGH Open. 2025 Aug 5;9(8):e70251. doi: 10.1002/jgh3.70251. eCollection 2025 Aug.

Abstract

BACKGROUND

Bouveret syndrome, a rare complication of cholelithiasis, is nonspecific symptoms and high mortality rates, with no established standard treatment. Here, we detail a case of effective endoscopic intervention in an elderly patient.

CASE PRESENTATION

A 91-year-old female patient who presented with a one-month history of nausea, vomiting, and significant abdominal distension. An abdominal CT scan revealed a biliary-enteric fistula, pneumobilia, gallstones, a calcified mass in the horizontal portion of the duodenum, and gastric dilatation. Endoscopic examination confirmed the presence of a biliary-enteric fistula and a large impacted gallstone in the duodenum. The patient subsequently underwent endoscopic lithotripsy and gallstone extraction, which successfully alleviated her symptoms.

CONCLUSION

The endoscopic management of Bouveret syndrome in elderly patients is both safe and efficacious. Clinicians should maintain suspicion for this uncommon condition when managing cholelithiasis patients presenting with signs of intestinal obstruction, emphasizing the significance of prompt intervention.

摘要

背景

布韦雷综合征是胆石症的一种罕见并发症,症状不具特异性且死亡率高,尚无既定的标准治疗方法。在此,我们详细介绍一例老年患者的有效内镜干预病例。

病例介绍

一名91岁女性患者,有1个月的恶心、呕吐及明显腹胀病史。腹部CT扫描显示胆肠瘘、气肿性胆囊炎、胆结石、十二指肠水平部钙化肿块及胃扩张。内镜检查证实存在胆肠瘘及十二指肠内一枚巨大嵌顿胆结石。该患者随后接受了内镜碎石及胆结石取出术,症状成功缓解。

结论

老年患者布韦雷综合征的内镜治疗安全有效。临床医生在处理出现肠梗阻体征的胆石症患者时,应始终怀疑这种罕见疾病,强调及时干预的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4613/12322685/f4ed88fdd023/JGH3-9-e70251-g001.jpg

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