Endoscopic Management of Bouveret's Syndrome in an Elderly Patient: A Case Report.

BACKGROUND

Bouveret syndrome, a rare complication of cholelithiasis, is nonspecific symptoms and high mortality rates, with no established standard treatment. Here, we detail a case of effective endoscopic intervention in an elderly patient.

CASE PRESENTATION: A 91-year-old female patient who presented with a one-month history of nausea, vomiting, and significant abdominal distension. An abdominal CT scan revealed a biliary-enteric fistula, pneumobilia, gallstones, a calcified mass in the horizontal portion of the duodenum, and gastric dilatation. Endoscopic examination confirmed the presence of a biliary-enteric fistula and a large impacted gallstone in the duodenum. The patient subsequently underwent endoscopic lithotripsy and gallstone extraction, which successfully alleviated her symptoms.

CONCLUSION

The endoscopic management of Bouveret syndrome in elderly patients is both safe and efficacious. Clinicians should maintain suspicion for this uncommon condition when managing cholelithiasis patients presenting with signs of intestinal obstruction, emphasizing the significance of prompt intervention.