Bouveret's syndrome complicated by acute pancreatitis.

BACKGROUND/AIM: This study evaluated a case of Bouveret's syndrome due to a cholecystoduodenal fistula and gallstone obstruction of the duodenum, complicated by acute pancreatitis and cholecystitis.

METHODS

The presenting features, special investigations, radiological findings, operative and endoscopic procedures were reviewed.

RESULTS

Symptoms persisted after laparotomy and removal of a gallstone in the duodenum. Intra-operative endoscopy identified a second previously undetected stone impacted in the distal duodenum.

CONCLUSION

The importance of excluding more than one stone causing Bouveret's syndrome is emphasized.