[Bouveret syndrome: report of four cases].

UNLABELLED: Bouveret syndrome is a duodenal obstruction caused by a biliary stone.

AIM: To report patients with Bouveret syndrome.

MATERIAL AND

METHODS

Retrospective review of medical records of patients with Bouveret syndrome treated between 1976 and 2006.

RESULTS

We report three women and one man with a mean age of 62.5 years. None had a previous diagnosis of cholelithiasis. AH presented with colicky pain in the right upper quadrant and vomiting, suggesting gastric retention. The diagnosis was suspected after a barium meal in two patients and with a CT scan on the other two. The endoscopical extraction or fragmentation of stones was attempted in three patients but was successful only in one. Three patients were operated and a stone impacted in the first portion of the duodenum was identified, along with a cholecystoduodenal fistula. A duodenostomy and stone extraction was performed. One patient was subjected to a cholecystectomy fistula repair and gastrojejunoanastomosis. No patient died and all were discharged within 8 to 12 days after surgery.

CONCLUSIONS

Bouveret syndrome is an uncommon complication of cholelithiasis. Endoscopy can be diagnostic and therapeutic. Surgery is the other therapeutic option.