Rare case report of choledocho-duodenal fistula with gastroduodenal outlet obstruction due to a large gallstone (Bouveret's syndrome).

We present a case of a 63 year old female patient admitted for acute epigastralgia and vomiting due to a large gallstone impacted in the first portion of the duodenum causing gastric outlet obstruction. The radiographic examination of the stomach (upper GI series with gastrografin) and abdominal ultrasound revealed the presence of a lesion (foreign body or gallstone) causing difficulty in drainage of gastric contents, with concomitant gastric dilatation and inability to tolerate any food ingestion. No symptoms from the gallbladder or bile ducts were present. A longitudinal incision on the anterior surface of the first portion of duodenum was performed and a large gallstones measuring 4.5 x 3cm was extracted. Additionally, a cholecystectomy was performed and a Kehr catheter was inserted in the common bile duct. Postoperative course was unremarkable. [ABSTRACT FROM AUTHOR]

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