Discussion of Bouveret syndrome
- Bouveret syndrome is a gastric outlet obstruction produced by a gallstone impacted in the distal stomach or proximal duodenum.
- Occurs most commonly in elderly women with a mean age of 69 years.
- The presenting clinical situation is variable and nonspecific but often includes nausea, vomiting, and epigastric pain.
- Early diagnosis is important because mortality is historically high at 33%, although it has decreased to 12% in recent years.
- Endoscopy is preferred as a therapeutic option because removal may be performed with mechanical, electrohydraulic, or laser lithotripsy.
- Surgery often is not desirable as the patients are often poor surgical candidates secondary to concomitant illnesses and advanced age.
 Imaging Findings for Bouveret syndrome
- Rigler triad: bowel obstruction, pneumobilia, and an ectopic gallstone.
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 References for Bouveret syndrome
- G. Brooks Brennan, Robert D. Rosenberg, and Sanjeev Arora. Bouveret Syndrome. RadioGraphics 2004 24: 1171-1175.