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báo cáo khoa học: "A challenging case of gastric outlet obstruction (Bouveret's syndrome): a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:A challenging case of gastric outlet obstruction (Bouveret's syndrome): a case report | PR JOURNALOF MEDICAL Ur CASE reports A challenging case of gastric outlet obstruction Bouveret s syndrome a case report Gajendran et al. BioMed Central Gajendran et al. Journal of Medical Case Reports 2011 5 497 http www.jmedicalcasereports.com content 5 1 497 4 October 2011 Gajendran et al. Journal of Medical Case Reports 2011 5 497 http www.jmedicalcasereports.eom content 5 1 497 JOURNALOF medical case reports CASE REPORT Open Access A challenging case of gastric outlet obstruction Bouveret s syndrome a case report Mahesh Gajendran1 Thiruvengadam Muniraj1 and Andres Gelrud2 Abstract Introduction Bouveret s syndrome is a clinically distinct form of gallstone ileus caused by the formation of a fistula between the biliary tract and duodenum. This case reinforces the need for early recognition and treatment of Bouveret s syndrome as it is associated with high morbidity and mortality rates. Case presentation An 82-year-old Caucasian woman presented with signs and symptoms of small bowel obstruction. Her laboratory workup showed elevated alkaline phosphatase and amylase levels. Computed tomography of her abdomen revealed pneumobilia a choledochoduodenal fistula and a gallstone obstructing her distal duodenum. The impacted gallstone could not be extracted endoscopically so our patient underwent open enterolithotomy successfully. However the postoperative course was complicated by myocardial infarction respiratory failure and disseminated intravascular coagulation. She died 22 days after surgery secondary to cardiopulmonary arrest. Conclusion This case clearly highlights the considerable morbidity and mortality associated with Bouveret s syndrome. Introduction Bouveret s syndrome is defined as a cholecystoduodenal or choledochoduodenal fistula with the passage of a gallstone into the duodenum or pylorus leading to gastric outlet obstruction 1 . There have been very few case reports about this syndrome published in the last 100 years because of its rarity. It is .