Bouveret's syndrome. Narrative review

Abstract

Obstruction at the level of the gastric outlet by a gallstone is defined as Bouveret's syndrome. It is an uncommon form of gallstone ileus. A single gallstone of at least 2.5 cm in diameter is the most common underlying cause of Bouveret's syndrome. Diagnosis is based on the clinical manifestations, existence of pneumobilia, visualization of lithiasis and demonstration of duodenal obstruction. Enterotomy or gastrotomy with or without cholecystectomy and fistula repair is the most common surgical therapy. It has high success rate, with acceptable surgical morbidity and mortality. Heightened awareness of this syndrome may lead to decreased morbidity and mortality.