A Case of Gallstone Ileus Impacted in the Duodenum (Bouveret's Syndrome)

Abstract

A 72-years-old woman was admitted to the hospital because of sudden onset of vomiting, epigastric pain, and back pain. Gastroduodenal endoscopy revealed the impacted giant gallstone in the duodenum and duodenal ulcer. We diagnosed it as a gallstone ileus.
We tried to crash the giant stone. But stone was not crashed. After the Gastroduodenal endoscopy, Laparotomy was performed. After cholecystectomy, the impacted gallstone was extracted from the fistula of the duodenal bulb. The duodenum was closed transversely and covered with omentum.
Duodenal obstraction by gallstone is rare cause of gallstone ileus. We report the case of gallstone ileus in the duodenum with review of 16 cases in the Japanease literature.