variant of Bouveret's syndrome

ABSTRACT

Bouveret`s syndrome is gastric outlet obstruction caused by impaction of a large gall stone in the duodenal bulb, through a cholecystoduodenal fistula. In this case, which is a variant of Bouveret's syndrome, a 58 years old lady presented with right upper quadrant abdominal pain and vomiting. Investigations, including MRCP, revealed a large stone impacted in the duodenal bulb and another one at the duodenojejunal junction causing dilatation of the stomach and the duodenum. She underwent laparotomy with cholecystectomy, closure of cholecystoduodenal fistula and an enterotomy to remove the stone impacted at the duedenojejunal junction