Bouveret Syndrome: a rare cause of gallstone ileus

Bouveret Syndrome (BS) is a rare complication of cholelithiasis in which a biliary stone from the gallbladder migrates into the duodenum via a cholecystoduodenal or cholecystogastric fistula, causing duodenal obstruction and resulting in high biliary ileus. The most common site of duodenal obstruction is at the duodenal bulb. The authors present the case of an 81-year-old patient who underwent surgery for 5 days of abdominal pain with a diagnosis of gallstone ileus. The paper points to BS as a rare complication of cholecystolithiasis with subsequent development of gallstone ileus and further to gallstone ileus as a rare cause of intestinal obstruction. Furthermore, this paper draws attention to the insidious clinical development of gallstone ileus and thus the postponement of surgery with an increase in morbidity and mortality of patients with a diagnosis of gallstone ileus. Computed tomography (CT) examination of the abdomen has a dominant role in diagnosing gallstone ileus. The appropriate surgical solution depends on the patient’s age, polymorbidity and general condition. Surgical therapy remains the most effective treatment method for gallstone ileus. Endoscopic therapy is used for high biliary ileus. Conservative treatment of biliary ileus is used only exceptionally in clinical practice and it is reserved for extremely high-risk polymorbid patients with a gallstone smaller than 2.5 cm.