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ABSTRACT: Bouveret’s syndrome, which is a gastric outlet obstruction caused by a gallstone in the duodenum, is a rare complication of
gallstone disease. We report a case of Bouveret’s syndrome in an 81-year-old woman who also exhibited incidental gallbladder
cancer. She was admitted to our hospital complaining of upper abdominal pain and vomiting. A computed tomography examination
showed a cholecystoduodenal fistula, a large impacted stone at the gastric outlet, and a dilated stomach. She was diagnosed
as having Bouveret’s syndrome. The patient underwent an upper gastrointestinal endoscopy and a mechanical lithotripsy was
successfully performed for the stone. She then underwent a cholecystectomy with primary closure of the duodenal fistula. An
intra-operative histopathology examination revealed severe cholecystitis with an adenocarcinoma in part of the gallbladder.
Gallbladder bed resection and regional lymph node dissection were also performed. To the best of our knowledge, this is the
first published report of a case in which Bouveret’s syndrome and gallbladder cancer co-existed.
KeywordsBouveret’s syndrome-Cholecystoduodenal fistula-Gallbladder cancer-Gallstone-Gastric outlet obstruction
Clinical Journal of Gastroenterology 01/2010; 3(5):248-253.