Case report

Bouveret's syndrome complicated by distal gallstone ileus after laser lithotropsy using Holmium: YAG laser

Mohammad M Alsolaiman , Christoph Reitz , Ali T Nawras , John B Rodgers and Benedict J Maliakkal

Division of Gastroenterology, Department of Medicine, Albany Medical College and VA Stratton Hospital, Albany, New York, USA

author email corresponding author email

BMC Gastroenterology 2002, 2:15doi:10.1186/1471-230X-2-15

Published:	18 June 2002

Abstract

Background

Bouveret's syndrome is an unusual presentation of duodenal obstruction caused by the passage of a large gallstone through a cholecystoduodenal fistula. Endoscopic therapy has been used as first-line treatment, especially in patients with high surgical risk.

Case presentation

We report a 67-year-old woman who underwent an endoscopic attempt to fragment and retrieve a duodenal stone using a Holmium: Yttrium-Aluminum-Garnet Laser (Ho:YAG) which resulted in small bowel obstruction. The patient successfully underwent enterolithotomy without cholecystectomy or closure of the fistula.

Conclusion

We conclude that, distal gallstone obstruction, due to migration of partially fragmented stones, can occur as a possible complication of laser lithotripsy treatment of Bouveret's syndrome and might require urgent enterolithotomy.