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  • Title: Erodes and bleeds, fistulises and obstructs: Bouveret's syndrome.
    Author: Kakadiya RB, Thakur U, Kaman L, Mandavdhare HS.
    Journal: Trop Doct; 2020 Oct; 50(4):383-385. PubMed ID: 32677541.
    Abstract:
    One of the rare complications of cholelithiasis is gallstone ileus which occurs in <5% of patients. Among them, <3% develop Bouveret's syndrome: gastric outlet obstruction by a large gallstone in the pylorus or duodenum. One large review of 128 patients showed it to present at a mean age of 74.1 ± 11.1 years with a mean gallstone size of 4.6 ± 1.5 cm, with nausea or vomiting in 86%, abdominal pain in 71% and haematemesis in 15%. The diagnosis is usually clear on oesophagogastroduodenoscopy or abdominal contrast-enhanced computed tomography. We present a case with massive upper gastrointestinal bleeding, due to erosion of a cystic artery pseudoaneurysm.
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