Bouveret's syndrome--case report.

BACKGROUND

Bouveret's syndrome is a rare complication of cholecystolithiasis with gastric outlet obstruction caused by a gallstone migrating through a biliogastric or bilioduodenal fistula. Gallstone ileus is mainly treated by surgery, either enterolithotomy or gastrotomy, with some cases being treated by endoscopic extraction.

CASE REPORT: We report on an 80-year-old woman without previous episodes of biliary colic, and known cholecystolithiasis who underwent emergency surgery due to pyloric obstruction caused by a large, 7-cm stone, after failure of endoscopic treatment. The stone was removed through pylorotomy, which was closed transversely in multiple layers and patched with omentum. The patient's postoperative course was complicated by operative wound infection. She was discharged on postoperative day 22 and had no complaints at the 6-month follow-up.