Case report highlights surgical management of fistula and gallstone in Bouveret syndrome, suggesting individualized approaches for better outcomes.
Bouveret syndrome is a rare cause of proximal gastrointestinal tract obstruction caused by the impaction of a gallstone migrating through a bilioenteric fistula, with the cholecystoduodenal fistula being the most common route. We present the case of a 76-year-old female patient with a history of chronic cholelithiasis who consulted due to nausea, persistent vomiting, epigastric pain, and early satiety. Imaging studies, including computed tomography (CT) and upper gastrointestinal endoscopy, revealed a large gallstone impacted in the second portion of the duodenum and a cholecystoduodenal fistula. Due to the size of the stone and failure of endoscopic extraction, surgical management was chosen, consisting of cholecystectomy, fistula closure, and stone removal, with favorable postoperative evolution. This case highlights the importance of early diagnosis and individualized management in Bouveret syndrome associated with cholecystoduodenal fistula to improve the prognosis of this rare but potentially serious condition.
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Mejia et al. (2025) studied this question.
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