Bouveret Sendromu: Migrate Safra Taşına Bağlı Gastrik Çıkış Obstrüksiyonu

Öz

Bouveret sendromu, mide çıkış obstrüksiyonunun nadir görülen bir nedenidir ve genellikle kronik inflamasyona bağlı olarak gelişen bilioenterik fistül yoluyla büyük bir safra taşının gastrointestinal sisteme göç etmesiyle ortaya çıkar. Risk faktörleri arasında 2,5 cm’den büyük safra taşı öyküsü, kadın cinsiyet ve ileri yaş yer alır. Bu olguda, 74 yaşında kadın hasta, 7 gündür devam eden epigastrik ve sağ üst kadran ağrısı, bulantı ve çok sayıda safralı kusma epizodları şikayetleriyle başvurdu. Kontrastlı batın bilgisayarlı tomografisi (BT) ve üst gastrointestinal endoskopi, duodenumun ilk kısmında obstrüksiyon yapan taş benzeri bir lezyonu ortaya koydu. Cholecystoduodenal fistüle bağlı, duodenumda sıkışmış safra taşı ile seyreden Bouveret sendromu tanısı konuldu ve cerrahi müdahale ile bu tanı doğrulandı.

Anahtar Kelimeler

• Safra Taşı
• Gastrik Çıkış Obstrüksiyonu
• Sindirim Sistemi Endoskopileri

Bouveret’s Syndrome: Gastric Outlet Obstruction from Migrated Gallstone

Öz

Bouveret’s syndrome is a rare etiology of gastric outlet obstruction, occurring when a large gallstone migrates into the gastrointestinal tract via a bilioenteric fistula, usually due to chronic inflammation. Risk factors include a history of gallstones larger than 2.5 cm, female gender, and advanced age. A 74-year-old female presented with a 7-day history epigastric and right upper quadrant pain, accompanied by nausea and multiple episodes of bilious vomiting. Contrast-enhanced computed tomography (CT) of the abdomen and an upper gastrointestinal endoscopy confirmed an obstructing stone lesion in the first part of the duodenum. A diagnosis of Bouveret’s syndrome, due to a cholecystoduodenal fistula with an impacted gallstone in the duodenum, was made and later confirmed through surgical intervention.

Anahtar Kelimeler

• Gallstone
• Gastric Outlet Obstructions
• Digestive System Endoscopies

Kaynakça

1. 1. Thatipalli N, Gattani R, Nayak K, Sudabattula K. Bouveret Syndrome: Etiology, Clinical Presentation, Differential Diagnosis, Complications, and Treatment Options. Cureus. 2024;16(7):e64754.
2. 2. Haddad FG, Mansour W, Deeb L. Bouveret’s Syndrome: Literature Review. Cureus. 2018;10(3):e2299.
3. 3. Caldwell KM, Lee SJ, Leggett PL, Bajwa KS, Mehta SS, Shah SK. Bouveret syndrome: current management strategies. Clin Exp Gastroenterol. 2018;11:69–75.
4. 4. Yu CY, Lin CC, Shyu RY, Hsieh CB, Wu HS, Tyan YS, et al. Value of CT in the diagnosis and management of gallstone ileus. World J Gastroenterol. 2005;11(14):2142–7.
5. 5. Cappell MS, Davis M. Characterization of Bouveret’s syndrome: a comprehensive review of 128 cases. Am J Gastroenterol. 2006;101(9):2139–46.
6. 6. Ong J, Swift C, Stokell BG, Ong S, Lucarelli P, Shankar A, et al. Bouveret Syndrome: A Systematic Review of Endoscopic Therapy and a Novel Predictive Tool to Aid in Management. J Clin Gastroenterol. 2020;54(9):758–68.
7. 7. Wang F, Du ZQ, Chen YL, Chen TM, Wang Y, Zhou XR. Bouveret syndrome: A case report. World J Clin Cases. 2019;7(23):4144–9.
8. 8. Philipose J, Khan HM, Ahmed M, Idiculla PS, Andrawes S. Bouveret’s Syndrome. Cureus. 2019;11(4):e4414.