Mirizzi-Induced Bouveret's Syndrome: Revelations of Timely Surgical Intervention

Daniel Stenberg; Mazen M Jamal; Harpreet Kaur; Massimo Arcerito

doi:10.1159/000522251

Mirizzi-Induced Bouveret's Syndrome: Revelations of Timely Surgical Intervention

Case Rep Gastroenterol. 2022 Apr 7;16(1):247-251. doi: 10.1159/000522251. eCollection 2022 Jan-Apr.

Authors

Daniel Stenberg¹, Mazen M Jamal², Harpreet Kaur³, Massimo Arcerito^{4

5}

Affiliations

¹ GME, UHS Southern California MEC, Temecula Valley Hospital, Temecula, California, USA.
² Gastroenterology Faculty, Oceana Gastroenterology Associate, Corona Regional Hospital, Corona, California, USA.
³ GME, School of Medicine at Government Medical College, Patiala, India.
⁴ Surgical Faculty, University of California Riverside, Riverside, California, USA.
⁵ Riverside Community Hospital, Riverside, California, USA.

Abstract

Bouveret's syndrome is an unusual clinical presentation of gastric-outlet obstruction and is the most infrequent variant of gallstone ileus with just over 300 cases in the literature. A 73-year-old female presented with innocuous constitutional symptoms and was found to have Mirizzi type Vb, a cholecystoduodenal fistula with obstruction. Esophago-gastroduodenoscopy-attempted dislodgement was unsuccessful. A gastric-jejunal bypass was the only option due to friability of the tissue. On post-op day 5, the patient developed acute abdominal pain and was found to have gallstone ileus. This case emphasizes the importance of early surgical intervention in cases of acute on chronic cholecystitis.

Keywords: Bouveret; Cholecystitis; Gallstone ileus; Gastric-outlet obstruction; Mirizzi.

Publication types

Case Reports