Slovenská chirurgia 4/2017
Bouveret´s syndrome as a cause of biliary ileus – case report
Bouveret syndrome refers to an obstruction in the doudenum at cholecystogastric and cholecystodoudenal fistula, where the presence of larger gallstones is the integral part of etiology. The disease is relatively rare and occurs more frequently in women over 40 than in men. The endoscopic examination and imaging methods have mostly been used in the clinical evaluation of the syndrome, since symptomato- logy and a laboratory image are not always specific. Morbidity and mortality have decreased in recent years due to early diagnosis, but also accompanying comorbidities play a significant role in the indicated surgical treatment. In our casuistic observations, we describe the case of a 64-year-old polymorbid patient who was transferred to the First Surgical Clinic of UPJŠ LF and UNLP Košice from a regional ICU Internal Clinic on account of suspected covered gallbladder perforation with cholecystitis and a suspected cholecysto-enteric fistula. The high-risk ASA 4 patient underwent a surgery due to the inability to intake food per os. This paper describes the symptomatology, the diagnostics, and our surgical procedure performed on account of the gallstones finding in the jejunum and the duodenum, which caused an obstruction of the passage through the digestive tract.
Keywords: gallstones, gallstone ileus, bilioenteric fistula, duodenal obstruction
