The usual cause is an underlying bilio-enteric fistula between the gallbladder and duodenum (cholecystoduodenal fistula) through which the stone migrates into. Gallstone ileus is peculiar because it can take the form of a high intestinal obstruction followed by a low intestinal obstruction as the stone travels down the. Cholecystoduodenal fistulas usually are caused by gallstones, eroding through the contact point of the inflamed gallbladder with the adjacent bowel, in contrast.

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There is only one reported case by Pickhardt et al. Successful treatment of gallstone ileus Bouveret’s syndrome by using extracorporeal shock wave lithotripsy and argon plasma coagulation. In addition, a secondary sign of presence fisttula contrast in the gallbladder may be a pointer towards the diagnosis.

Malignant tumors can cause fistula too [1,2].

The usual cause is an underlying bilio-enteric fistula between the gallbladder and duodenum cholecystoduodenal fistula through which the stone migrates into the bowel. Bouveret syndrome was first described by Leon Bouveret in However, the ectopic location of the gallstone within the intestinal lumen may be confused with an orthotopic location in a contracted gallbladder.

Cholecystoduodenal Fistula: A Case Report

Keywords Our case is of 42 years old female. The gallbladder was collapsed and revealed thickened walls.

Gallstone ileus itself is a rare presentation of the gallstone disease occurring in 0. A 5-cm sized calculus was noted fistupa the third part of duodenum beyond which the scope was not negotiable.


Subsequent radiographs may demonstrate a shift in position of the radio-opaque stone. Purchase access Subscribe now. Cholecystectomy was done and fistula was sutured. A retrospective study was conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to choleecystoduodenal, cholecystitis, or cholangitis, within a 3-year time frame. Coronal T2W image revealing cholecystoduodenal fistula marked with arrow. CT study of the abdomen was not possible since the patient was vomiting and could not tolerate oral contrast.

Classification, etiologies, and imaging evaluation. Rev Esp Enferm Dig. Repeated attempts at endoscopic retrieval along with extracorporeal shock wave and mechanical lithotripsy proved fruitless and the patient was taken up for surgery. The gallbladder is collapsed, thickened, and adherent to the second part of duodenum. Purchase access Subscribe to JN Learning for one year.

Create a personal account to register for email alerts with links to free full-text articles. Conclusion To conclude, Bouveret syndrome is an unusual and a rare complication of gallstone disease. Successful treatment of duodenal bulb obstruction caused by a gallstone Bouveret’s syndrome after endoscopic mechanical lithotripsy.

The cholecystoduodenal fistula was well demonstrated on thick slab images [ Figure 5 ]. Omentoplasty was applied on the sutured fistula’s region. This article has been cited by other articles in PMC. CT is considered more accurate than ultrasound 2 and allows direct visualization of a tract between the gallbladder and the duodenum.

Bouveret syndrome: Primary demonstration of cholecystoduodenal fistula on MR and MRCP study

Indian J Radiol Imaging. Please review our privacy policy. Can’t read the image? Abstract Bouveret syndrome is an unusual complication of cholelithiasis which results in upper gastrointestinal obstruction due to a gallstone impacted in the duodenum through choledystoduodenal bilio-enteric fistula. The individual was otherwise anicteric and his vital parameters were stable. Axial T2W image showing a large hypointense calculus obstructing the third part of duodenum marked with a star.


Dilated CBD is also seen. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more.

Cholecysto duodenal fistulation Cholecysto duodenal fistulas Cholecysto-duodenal fistula Cholecystoduodenal tistula. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.

Cholecystoduodenal fistula | Radiology Reference Article |

Laparoscopic cholecystectomy was intended for the patient, this was converted to open cholecystectomy because of the dense adhesions between gall bladder and duodenum. The Rigler’s triad is easily identifiable as is the bilio-enteric fistula which is usually delineated cholecyxtoduodenal air or oral contrast.

Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. She was applied to us for cholecystectomy.