Bouveret Syndrome

Bouveret syndrome refers to gastric outlet obstruction caused by the migration of a gallstone through a cholecyst-enteric fistula into the proximal duodenum. It is a very rare phenomenon and has been reported most commonly in elderly female. We present a case of Bouveret syndrome in a middle aged man, who was managed surgically Ultrasonography showed features suggestive of stone in gall bladder. Rest of the organs including the common bile duct was reported normal. Blood investigations were essentially normal. A diagnosis of cholelithiasis with acute or chronic cholecystitis was made and the patient was treated with intravenous antibiotics and an open cholecystectomy was planned after 6 weeks. At operation, a densely adherent mass was encountered with inseparable adhesions between Gall bladder, omentum and duodenum. Biopsy was taken from gall bladder mass and cholecystectomy was abandoned. The patient made uneventful recovery. Biopsy was suggestive of Xanthogranulomatous cholecystitis. It was then decided to allow the dense inflammation to subside and elective surgery was deferred for 4-5 months.

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Last date updated on July, 2025