Case Reports in Gastroenterology
Published: July 2012
Complicated Cholelithiasis: An Unusual Combination of Acute Pancreatitis and Bouveret SyndromeBaloyiannis I.a · Symeonidis D.a · Koukoulis G.a · Zachari E.a · Potamianos S.b · Tzovaras G.aDepartments of aGeneral Surgery and bGastroenterology, University Hospital of Larissa, Larissa, Greece
Georgios Koukoulis, MD Falani Larisa GR–40011 Larissa (Greece) Tel. +30 694 592 1218 E-Mail georgios.koukoulis@gmail.com |
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Abstract
Bouveret syndrome is a rare form of gallstone ileus. The purpose of the present study was to present the unusual case of a female patient with complicated cholelithiasis manifested as a combination of acute pancreatitis and concomitant Bouveret syndrome. A 61-year-old female patient was admitted to the emergency department complaining of mid-epigastric and right upper quadrant abdominal pain radiating band-like in the thoracic region of the back as well as repeated episodes of vomiting over the last 24 h. The initial correct diagnosis of pancreatitis was subsequently combined with the diagnosis of Bouveret syndrome as a computed tomography scan revealed the presence of a gallstone within the duodenum causing luminal obstruction. After failure of endoscopic gallstone removal, a surgical approach was undertaken where gallstone removal was followed by cholecystectomy and restoration of the anatomy by eliminating the fistula. The concomitant pancreatitis complicated the postoperative period and prolonged the length of hospital stay. However, the patient was discharge on the 45th postoperative day. Attempts for endoscopic removal of the impacted stone should be the initial therapeutic step. Surgery should be reserved for cases refractory to endoscopic intervention and when definite treatment is the actual challenge.
© 2012 S. Karger AG, Basel
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Article / Publication Details
Published online: July 12, 2012
Issue release date: May – August
Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 0
eISSN: 1662-0631 (Online)
For additional information: https://www.karger.com/CRG
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