Endoscopic Management of Bouveret's Syndrome in an Elderly Patient: A Case Report

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2025-08-05 DOI:10.1002/jgh3.70251

Meng Zhang, Ya-Nan Sun, Feng Gao, Yong Sun, Wen Jia, Jian-Feng Huo, Jiang-Ning Gu, Zhuo Yang

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Abstract

Background

Bouveret syndrome, a rare complication of cholelithiasis, is nonspecific symptoms and high mortality rates, with no established standard treatment. Here, we detail a case of effective endoscopic intervention in an elderly patient.

Case Presentation

A 91-year-old female patient who presented with a one-month history of nausea, vomiting, and significant abdominal distension. An abdominal CT scan revealed a biliary-enteric fistula, pneumobilia, gallstones, a calcified mass in the horizontal portion of the duodenum, and gastric dilatation. Endoscopic examination confirmed the presence of a biliary-enteric fistula and a large impacted gallstone in the duodenum. The patient subsequently underwent endoscopic lithotripsy and gallstone extraction, which successfully alleviated her symptoms.

Conclusion

The endoscopic management of Bouveret syndrome in elderly patients is both safe and efficacious. Clinicians should maintain suspicion for this uncommon condition when managing cholelithiasis patients presenting with signs of intestinal obstruction, emphasizing the significance of prompt intervention.

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老年布韦莱特综合征的内镜治疗：1例报告

背景：Bouveret综合征是胆石症的一种罕见并发症，是一种非特异性症状，死亡率高，没有既定的标准治疗方法。在这里，我们详细介绍了一例有效的内镜干预在一个老年病人。91岁女性患者，有恶心、呕吐和明显腹胀一个月的病史。腹部CT扫描显示胆肠瘘，气动症，胆结石，十二指肠水平部分钙化肿块，胃扩张。内窥镜检查证实存在胆道-肠瘘和十二指肠一大块阻生胆结石。随后，患者接受了内镜碎石术和胆结石取出术，成功缓解了症状。结论内镜下治疗老年布韦莱特综合征安全有效。临床医生在处理出现肠梗阻症状的胆石症患者时应保持对这种罕见情况的怀疑，强调及时干预的重要性。

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