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Bouveret Syndrome

Bouveret syndrome is a rare condition that occurs when a large gallstone becomes lodged in the duodenum, which is the first part of the small intestine. This can cause a blockage, which can lead to symptoms such as abdominal pain, nausea, vomiting, and jaundice.

History Of Patient:-

Elderly female with acute epigastric abdominal pain.

The CT abdomen show Bouveret syndrome.

Celestina Osei-Boateng impacted gall stone at distal 3rd part of duodenum causing proximal dilation of duodenum. There’s also a distended stomach seen as a fluid filled round structure.

Diagnosis:- Bouveret Syndrome

What Is Bouveret Syndrome?

Bouveret syndrome is a rare condition that occurs when a large gallstone becomes lodged in the duodenum, which is the first part of the small intestine. This can cause a blockage, which can lead to symptoms such as abdominal pain, nausea, vomiting, and jaundice.

The syndrome is named after Leon Bouveret, a French physician who first described the condition in 1896. It is more common in elderly women and those with a history of gallstones.

Bouveret syndrome can be diagnosed with imaging tests such as a CT scan, MRI, or endoscopy. Treatment may involve surgery to remove the gallstone, or in some cases, non-surgical methods such as endoscopic removal or shock wave lithotripsy may be used.

Bouveret syndrome is a rare but serious condition that requires prompt diagnosis and treatment to prevent complications such as bowel obstruction, infection, or organ damage.

Clinical Symptoms.

The clinical symptoms of Bouveret syndrome can vary from person to person, but typically include:-

Abdominal pain:- This is usually a constant, severe pain that is felt in the upper right quadrant of the abdomen.

Nausea and vomiting:- These symptoms are common and may be severe, leading to dehydration.

Jaundice:- A yellowing of the skin and whites of the eyes due to the buildup of bilirubin in the blood.

Loss of appetite:- This can be caused by the pain and nausea associated with the condition.

Weight loss:- This may occur as a result of reduced appetite and vomiting.

Constipation:- Due to the obstruction caused by the gallstone.

Fever:- This may occur if there is an infection or inflammation associated with the condition.

If you are experiencing any of these symptoms, it is important to seek medical attention promptly to determine the underlying cause and receive appropriate treatment.

How To Diagnose.

Bouveret syndrome is a rare condition and can be challenging to diagnose. However, several diagnostic tests can help identify the condition, including:-

Imaging tests:- Imaging tests such as CT scan, MRI, or ultrasound can help detect the presence of a gallstone in the duodenum.

Upper gastrointestinal endoscopy:- A thin, flexible tube with a camera on the end is inserted through the mouth to the stomach and duodenum to visualize the gallstone and assess the extent of the obstruction.

Blood tests:- These tests can help identify any abnormalities in liver function, which may be caused by the blockage of the bile duct.

Barium swallow:- This test involves swallowing a liquid containing barium, which can help detect any blockages in the digestive tract.

ERCP:- Endoscopic retrograde cholangiopancreatography can be performed to visualize the bile duct and confirm the diagnosis.

The diagnosis of Bouveret syndrome may require a combination of these diagnostic tests, and it is crucial to seek medical attention promptly if you experience symptoms suggestive of this condition.

Treatment and prognosis Bouveret syndrome

The treatment of Bouveret syndrome depends on the severity of the obstruction and the overall health of the patient. The main treatment options include:-

Surgery:- Surgical intervention is the most common treatment for Bouveret syndrome. The procedure involves removing the gallstone causing the obstruction, either by open surgery or laparoscopic surgery.

Endoscopy:- Endoscopic removal of the gallstone may be attempted in some cases, using a flexible tube with a camera and tools to retrieve the stone from the duodenum.

Shock wave lithotripsy:- This non-surgical treatment may be used to break up the gallstone into smaller pieces that can be passed through the digestive tract.

Supportive care:- Patients with Bouveret syndrome may require supportive care such as intravenous fluids, electrolyte replacement, and pain management.

The prognosis for Bouveret syndrome is generally good if the condition is diagnosed and treated promptly. However, if left untreated, it can lead to serious complications such as bowel obstruction, infection, and organ damage, which can be life-threatening.

It is important to seek medical attention promptly if you experience symptoms of Bouveret syndrome to prevent complications and improve the chances of a successful outcome.

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