Bouverets syndrom - när gallsten orsakar stopp i duodenum. Ovanlig och mycket svår diagnos att ställa
Engelsk titel: Bouveret syndrome - when gallstone causes duodenal obstruction. Unusual and very difficult diagnosis to make
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Författare:
Aven, Helena
;
Gözen, Mehmet
Email: helena.aven@ltkalmar.se
Språk: Swe
Antal referenser: 10
Dokumenttyp:
Fallbeskrivning
UI-nummer: 14117481
Sammanfattning
Bouveret syndrome is an unusual cause of gallstone ileus where a stone in the duodenum causes obstruction of the ventricular outflow. The stone reaches the duodenum
through a bilioduodenal fistula developed after earlier cholecystitis. We encountered two patients in a short period of time with this syndrome. One suffered from nausea,
vomiting and pain and the other from haematemesis. Diagnosis was done through computer tomography of the abdomen, which is the best diagnostic tool in these cases,
revealing pneumobilia, a gallstone in the duodenum and ventricular retention. Our first patient was treated by splitting the stone endoscopically. In the other patient the stone
proceeded to the horizontal part of the duodenum and had to be taken out surgically by a small duodenotomy. A decision was made not to remove the gallbladder in both these
cases; whether that should be done or not is controversial.