Pyloric stenosis caused by gallstone (Bouveret's syndrome). Presentation of a further case

The Bouveret's syndrome is a rare complication of a bilio-digestive fistula, where a big stone occludes the pyloro-duodenal region. The clinical symptomatology is atypical, symptoms of the disease are acute and only in fifty per cent of cases it is possible to have a positive anamnesis for biliary lithiasis. The evolution of the occlusion is generally rapid. The clinical case we are in possession of, shows a particularly chronic evolution with a 15 month sub-occlusive symptomatology that caused a massive gastric dilatation. The diagnosis of Bouveret syndrome was set forth during operation, as generally happens in about 50% of cases. The surgical treatment is still the only one capable to solve the obstruction of the alimentary canal and the bilio-digestive fistula at the same time.