tailieunhanh - báo cáo khoa học: "Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome) four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome) four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report | Giese et al. Journal of Medical Case Reports 2010 4 376 http content 4 1 376 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Development of a duodenal gallstone ileus with gastric outlet obstruction Bouveret syndrome four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis a case report Arnd Giese1 Jurgen Zieren2 Guido Winnekendonk3 Bernhard F Henning1 Abstract Introduction Cases of gallstone ileus account for 1 to 4 of all instances of mechanical bowel obstruction. The majority of obstructing gallstones are located in the terminal ileum. Less than 10 of impacted gallstones are located in the duodenum. A gastric outlet obstruction secondary to a gallstone ileus is known as Bouveret syndrome. Gallstones usually enter the bowel through a biliary enteral fistula. Little is known about the formation of such fistulae in the course of gallstone disease. Case presentation We report the case of a 72-year-old Caucasian woman born in Germany with a gastric outlet obstruction due to a gallstone ileus Bouveret syndrome with a large gallstone impacted in the third part of the duodenum. Diagnostic investigations of our patient included plain abdominal films gastroscopy and abdominal computed tomography which showed a biliary enteric fistula between the gallbladder and the duodenal bulb. Our patient was successfully treated by laparotomy duodenotomy extraction of the stone cholecystectomy and resection of the fistula in a one-stage surgical approach. Histopathological examination showed chronic and acute cholecystitis with perforated ulceration of the duodenal wall and acute purulent inflammation of the surrounding fatty tissue. Four months prior to developing a gallstone ileus our patient had been hospitalized for cholecystitis a large gallstone in the gallbladder cholangitis and a small obstructing gallstone in the common biliary duct. She had been treated with endoscopic retrograde .