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Bouveret’s syndrome treated with endoscopic electrohydraulic lithotripsy
  1. Aysun Avci,
  2. Ismail Gögenur and
  3. Mustafa Bulut
  1. Department of Surgery, Zealand University Hospital, Køge, Denmark
  1. Correspondence to Aysun Avci, ayav{at}


Bouveret’s syndrome is a rare form of small bowel obstruction caused by a large biliary stone entering the lumen of the duodenum or the stomach through a bilioenteric fistula. Treatment options include various surgical techniques. However, recent advances in endoscopy also allow non-surgical endoscopic treatment options. We report a 68-year-old man, with a disseminated small intestinal neuroendocrine tumour, presenting with Bouveret’s syndrome without any previously reported biliary disease. He experienced a number of symptoms 1 month prior to his admittance, which were difficult to differentiate from other infectious diseases and complications due to his neuroendocrine tumour. Abdominal CT showed a biliary stone impacted in the duodenal bulb, small bowel obstruction, pneumobilia and a bilioenteric fistula. The patient was treated with endoscopic electrohydraulic lithotripsy to fragment the large gallstone in smaller retractable pieces. The patient avoided major surgery and was discharged the following day.

  • endoscopy
  • surgery
  • gastrointestinal surgery
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  • Contributors MB was the surgeon performing the endoscopic procedure. AA drafted this manuscript, and IG oversaw its production and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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