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Bouveret syndrome: a rare complication of gallstone disease
  1. Akbar Karimi1,2,
  2. Omar Ghandour1,3 and
  3. Christopher Wong3
  1. 1Bristol Medical School, University of Bristol, Bristol, UK
  2. 2Intensive Care, Chelsea and Westminster Healthcare NHS Trust, London, UK
  3. 3General Surgery, North Bristol NHS Trust, Westbury on Trym, Bristol, UK
  1. Correspondence to Dr Omar Ghandour; omar.ghandour{at}


A Caucasian man in his late 80s was admitted with central abdominal pain, abdominal distension and continuous vomiting, on the background of a recent admission for acute cholecystitis. The patient was managed for subacute bowel obstruction and was admitted to general surgery for further investigation. His blood tests showed raised inflammatory markers and deranged liver function tests. A CT scan showed the migration of a large gallstone, previously seen in the neck of the gallbladder on prior admission, to the proximal duodenum causing a degree of gastric outlet obstruction. A diagnosis of Bouveret syndrome was made, and although initially managed conservatively, the patient ultimately underwent surgery to remove the gallstone which had relocated again to the terminal ileum. Our case highlights the importance of considering rare complications such as Bouveret syndrome in patients presenting with bowel obstruction, particularly in the context of recent or chronic cholecystitis.

  • surgery
  • general surgery
  • gastrointestinal surgery
  • gastroenterology
  • pancreas and biliary tract

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  • Contributors AK and OG contributed equally to the manuscript as joint first authors. The project was supervised by CW.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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