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Sonographic diagnosis of Bouveret's syndrome

✍ Scribed by Sudhakar Kundapur Venkatesh; Manigandan Subramaniam Thyagarajan; Ratni Bajaj Gujral; Archana Gupta

Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
118 KB
Volume
31
Category
Article
ISSN
0091-2751

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✦ Synopsis

A case of Bouveret's syndrome with obstruction of the duodenojejunal flexure diagnosed preoperatively by sonography is presented. A 48-year-old man with a history of cholelithiasis presented with colicky pain of 2 days' duration. Real-time sonography revealed a fluid-distended stomach and duodenum and a 3.4-cm bright curvilinear echo with dense shadowing in the duodenojejunal flexure, suggesting a gallstone. In addition, there was pneumobilia and evidence of chronic cholecystitis. The findings were confirmed with CT, which showed a partially calcified gallstone at the duodenojejunal flexure, pneumobilia, and a fistulous communication between the gallbladder and duodenum. At surgery, a large gallstone was found impacted at the duodenojejunal flexure. The stone and gallbladder were successfully removed and the fistula repaired. The sonographic diagnosis of Bouveret's syndrome enabled early surgical intervention.

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