The usual cause is an underlying bilio-enteric fistula between the gallbladder and duodenum (cholecystoduodenal fistula) through which the stone migrates into. Gallstone ileus is peculiar because it can take the form of a high intestinal obstruction followed by a low intestinal obstruction as the stone travels down the. Cholecystoduodenal fistulas usually are caused by gallstones, eroding through the contact point of the inflamed gallbladder with the adjacent bowel, in contrast.

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Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Computed tomography CT scan has been useful as a diagnostic modality for demonstration of the obstructing calculus and the bilio-enteric fistula.

Gallstone ileus itself is a rare presentation of the gallstone disease occurring in 0. Thank you for updating your details. The rarity of this entity in clinical practice is also evidenced by only up to reported cases in literature. Endoscopic removal cholecystoduodsnal a gallstone obstructing the upper jejunum.

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Classification, etiologies, and imaging evaluation. This may be especially valuable in demonstrating isoattenuating stones and in patients who are unable to tolerate oral contrast medium. In our case too, owing to the unstable condition of the patient, a decision to delineate the pathology on magnetic resonance imaging MRI study of the abdomen was undertaken with successful demonstration of the impacted gallstone as well as the cholecystoduodenal fistula. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.


Contracted chronic cholecystitis with gallstone is diagnosed in ultrasonographic examination. Pathologic examination result was benign. Cholecystoduodenal fistula refers to a fistulous connection between the gallbladder and the duodenum. Case 3 Case 3. Per-operatively, the gallbladder was collapsed with dense supracolic adhesions and a frozen C-loop.


The gallbladder was collapsed and revealed thickened walls. To identify the incidence of bilioenteric fistula in patients with gallstones, its clinical presentation, diagnosis through imaging study, surgical management, postoperative complications, and follow-up. MRI and MRCP studies can also act as cholecystodjodenal adjuncts in imaging of this disease for primary demonstration of the bilio-enteric fistula in cases where oral contrast fistulw not well tolerated.

Coronal T2W image showing a large calculus marked with a star lodged in the third part of duodenum with proximally dilated gas-filled bowel.

Bouveret syndrome: Primary demonstration of cholecystoduodenal fistula on MR and MRCP study

Malignant tumors can cause fistula too [1,2]. Please review our privacy policy. Historically, abdominal radiograph demonstrating classical Rigler’s triad of bowel obstruction, pneumobilia, and an ectopic gallstone has been described in gallstone ileus. Fistjla diagnosis of the fistula may be impossible.

Cholecystoduodenal Fistula: A Case Report | Insight Medical Publishing

cholecystoduoednal Upper gastrointestinal GI endoscopy of the patient revealed a cholecystoduodenal fistula in the second part of duodenum. Fistula is very important and complicated situations. Articles Cases Courses Quiz.

Create a free personal account to download free article PDFs, sign up for alerts, and more. The incidence of cholecystoduodenal fistula was similar to that reported in the medical literature. Purchase access Subscribe now. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. Gallstone ileus is peculiar because it can take the form of a high intestinal obstruction followed by a low intestinal obstruction as the stone travels down the bowel.


Singh N, Stempel K. She was applied to us for cholecystectomy. Successful treatment of duodenal bulb obstruction caused by a gallstone Bouveret’s syndrome after endoscopic mechanical lithotripsy. Our website uses cookies to enhance your experience.

Bouveret syndrome was first described by Leon Bouveret in Get free access to newly published articles Create a personal account or sign in to: The patient showed smooth recovery up to the 5 th post-operative day when he developed sepsis and he succumbed to multi-organ system failure on the 10 th day. The fistulous tract filled with air or fluid may further be confused with common bile duct.

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Very dense adhesion is diagnosed between gall bladder and duodenum. Abstract Bouveret syndrome is an unusual complication of cholelithiasis which results in upper gastrointestinal obstruction due to a gallstone impacted in the duodenum through a bilio-enteric fistula.

Indian J Radiol Fiztula. Introduction Bouveret syndrome cholecystduodenal a rare form of gallstone ileus which occurs due to impaction of the stone in the duodenum. Author information Copyright and License information Disclaimer. Conclusion To conclude, Bouveret syndrome is an unusual and a rare complication of gallstone disease.