Bouveret's Syndrome Presenting as Upper Gastrointestinal Hemorrhage Without Hematemesis

Jones, Terrance A.; Davis, Mark E.; Glantz, Andrew I.
August 2001
American Surgeon;Aug2001, Vol. 67 Issue 8, p786
Academic Journal
A 74-year-old woman with a recent diagnosis of peptic ulcer disease diagnosed by endoscopy after presentation with an episode of upper gastrointestinal bleeding returned 6 1/2 weeks later with a 5-day history of nausea and vomiting without associated symptoms. An ultrasound was nondiagnostic except for a large gallstone and a poorly visualized gallbladder. Repeat endoscopy revealed a hard mass that was presumed to have formed secondarily to an ulcer-induced stricture, and a 6-cm filling defect just proximal to the duodenal bulb was seen on a preoperative upper gastrointestinal series. At laparotomy the mass was actually a large gallstone and two smaller stones, which had eroded into and become impacted in the duodenal bulb creating a gastric outlet obstruction. The stones were extracted via a duodenotomy, and the remaining portion of the gallbladder was removed with repair of the cholecystoduodenal fistula. The patient was discharged home after an uncomplicated postoperative course. Gastric outlet obstruction by a duodenal gallstone is a condition known as Bouveret's syndrome, which is a rare complication of gallstone disease. Upper gastrointestinal hemorrhage is an especially rare form of presentation.


Related Articles

  • Bouveret's Syndrome Presenting as Upper Gastrointestinal Hemorrhage. Chait, Maxwell M.; Lerner, Arthur G. // American Journal of Gastroenterology;Dec1986, Vol. 81 Issue 12, p1199 

    A unique case of hematemesis is presented. The cause of upper gastrointestinal bleeding was a pyloroduodenal ulcer caused by erosion of a 5-cm gallstone impacted in the duodenal bulb. On review of the world literature of Bouveret's syndrome, this is the first case in which a preoperative...

  • Getting to the bottom of a bloody mystery. Rogers, Arvey I.; Tagle, Martin // Patient Care;4/30/1996, Vol. 30 Issue 8, p70 

    Presents the case of a 54-year old man who was referred by his physician for evaluation of episodes of hematemesis, the vomiting of blood, which occurred two months before his present hospital admission. What the patient denies taking; Why endoscopy was performed on the patient.

  • Successful Multimodality Endoscopic Treatment of Gastric Outlet Obstruction Caused by an Impacted Gallstone (Bouveret's Syndrome). Rogart, Jason N.; Perkal, Melissa; Nagar, Anil // Diagnostic & Therapeutic Endoscopy;2008, p1 

    Bouveret's syndrome is a rare condition of gastric outlet obstruction resulting from the migration of a gallstone through a choledochoduodenal fistula. Due to the large size of these stones and the difficult location in which they become impacted, endoscopic treatment is unsuccessful and most...

  • Gallstones cost $5 billion.  // Obesity & Health;Mar/Apr93, Vol. 7 Issue 2, p31 

    Reports how the National Institutes of Health consensus statement from the September 1992 NIH Consensus Conference on Gallstones and Laparoscopic Cholecystectomy found that gallstones are more prevalent in women than men. How more than 20 million Americans have gallstones; Estimated yearly cost...

  • Gastroenterology.  // Patient Care;7/15/1993, Vol. 27 Issue 12, p149 

    Reviews the article `Approaches to the Management of Cholelithiasis for the Medical Consultant,' by Goldschmid S. and Brady PG.

  • The history of cholelithiasis. Hendry, Angela; O'Leary, J. Patrick // American Surgeon;Aug1998, Vol. 64 Issue 8, p801 

    Presents a historical background to cholelithiasis. Earliest cases of gallstones in Mycenae, Greece; Description of gallstones in humans by Alexander of Tralles; Description of cholecystitis by Gentile da Foligno; Jean Fernel's description of cholelithiasis; First removal of gallstone by...

  • Midtorso mystery pain: Which steps to take? Ratner, Douglas; Saxena, Madhu // Patient Care;6/15/1995, Vol. 29 Issue 11, p167 

    Presents the case of a 71-year-old female with abdominal pain due to gallstone ileus. Medical history and physical examination; Results of upper abdominal films; Laboratory findings; Findings on endoscopic retrograde cholangiopancreatography; Complications of harboring stones larger than 2.5...

  • Lessons from the RCS quality improvement collaborative Chole-QuIC. Bamber, J; Stephens, T; Beckingham, I // Bulletin of The Royal College of Surgeons of England;2019, Vol. 101 Issue 5, p190 

    Highlights from the article: Quality improvement (QI) provides a simple structure and method to improve care and solve the seemingly intransigent problems we see in our day-to-day work. Clinical evidence and guidance suggest that, compared with delayed elective surgery, early emergency...

  • hematemesis.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1034 

    A definition of the medical term "hematemesis," which refers to the vomiting of blood that may be clotted, fluid or mixed with food, is presented.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics