Bouveret's syndrome: a rare clinical variant of gallstone ileus

Bouveret's syndrome is a rare complication of gallstone disease characterized by gastric outlet obstruction due to impaction of single or multiple gallstones which have migrated through a bilio-enteric fistula. The main symptoms are nausea, vomiting and epigastric pain. The diagnosis is achieved by plain film of the abdomen, ultrasonography and CT scan, which reveal aerobilia (an indirect sign of bilio-enteric fistula), and the obstructing gallstone. The treatment of this condition requires removal of the stone through an endoscopic or surgical approach, and possible cholecystectomy with closure of the fistula. The Authors report a case of Bouveret's syndrome in an 86-year-old female patient who underwent successful surgical treatment.