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Sonographic diagnosis of Bouveret's syndrome
Author(s) -
Venkatesh Sudhakar Kundapur,
Thyagarajan Manigandan Subramaniam,
Gujral Ratni Bajaj,
Gupta Archana
Publication year - 2003
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.10149
Subject(s) - medicine , gallbladder , duodenum , fistula , radiology , gastric outlet obstruction , chronic cholecystitis , cholecystitis , surgery
A case of Bouveret's syndrome with obstruction of the duodenojejunal flexure diagnosed preoperatively by sonography is presented. A 48‐year‐old man with a history of cholelithiasis presented with colicky pain of 2 days' duration. Real‐time sonography revealed a fluid‐distended stomach and duodenum and a 3.4‐cm bright curvilinear echo with dense shadowing in the duodenojejunal flexure, suggesting a gallstone. In addition, there was pneumobilia and evidence of chronic cholecystitis. The findings were confirmed with CT, which showed a partially calcified gallstone at the duodenojejunal flexure, pneumobilia, and a fistulous communication between the gallbladder and duodenum. At surgery, a large gallstone was found impacted at the duodenojejunal flexure. The stone and gallbladder were successfully removed and the fistula repaired. The sonographic diagnosis of Bouveret's syndrome enabled early surgical intervention. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:163–166, 2003