Article Text

PDF
Mechanical lithotripsy for Bouveret’s syndrome
  1. Muhammad Afzal1,
  2. Debabrata Ghosh1,
  3. Timothy Leigh1
  1. 1Department of Gastroenterology, East Surrey Hospital, Redhill, Surrey, UK
  1. Correspondence to:
    Dr M Afzal
    Department of Gastroenterology, East Surrey Hospital, Redhill, Surrey, RH1 5RH, UK; mafzalmrcp{at}yahoo.co.uk

Statistics from Altmetric.com

We read with interest the editor’s quiz about Bouveret’s syndrome by Yau et al (Gut 2006;55:373, 387). We noted the comments that these cases are usually dealt with surgically, and carry a high morbidity. Recently, we had a similar case, which was managed without surgical intervention using mechanical lithotripsy as normally used at endoscopic retrograde cholangiopancreatography, avoiding the need for laparoscopic surgery.

A 79-year-old woman was admitted with a 2-month history of recurrent vomiting, abdominal pain and weight loss. A CT scan of the abdomen showed a grossly dilated stomach suggestive of gastric outlet obstruction due to stones in the second part of the duodenum (D2). A subsequent gastrografin follow through showed duodenal obstruction and a cholecystoduodenal fistula.

An oesophagogastroduodenoscopy showed an inflamed and narrowed pylorus with malignant-looking ulcer and apparent gallstones in the D2. To relive the symptoms of obstruction, …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.