Successful Treatment of Bouveret Syndrome by Electrohydraulic Lithotripsy and Double Balloon Endoscopy
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Rare disease
Ryoko Futai, Takao Iemoto, Yuta Inoue, Mika Miki, Tetsuyuki Abe, Shohei Abe, Ayaka Sasaki, Katsuhide Tanaka, Tomoo Yoshie, Takayuki Ose, Teruhisa Morikawa, Tsuyoshi Sanuki
(Department of Gastroenterology, Kita-Harima Medical Center, Ono, Hyogo, Japan)
Am J Case Rep 2019; 20:1320-1324
Bouveret syndrome is a rare complication of cholelithiasis that often leads to symptoms of gastric outlet obstruction.
CASE REPORT: An 84-year-old woman developed acute abdominal symptoms due to impaction of a gallstone in the horizontal part of the duodenum. The diagnosis was supported by abdominal computed tomography and double balloon endoscopy. Considering her advanced age and the position of the calcified gallstone, we decided to perform electrohydraulic lithotripsy using double balloon endoscopy for treatment. Finally, the impacted stone was removed with reduced size. She was discharged home 10 days after admission without recurrence.
CONCLUSIONS: This case illustrates that electrohydraulic lithotripsy using double balloon endoscopy is very effective, especially for treatment of Bouveret syndrome caused by gallstone impaction in the horizontal part of the duodenum.
Keywords: Gallstones, Ileus, Lithotripsy