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Background <p>Bouveret syndrome is a rare presentation of gastric outlet obstruction secondary to a gallstone impacted at the duodenal bulb. The disease usually occurs in elderly females, often frail with operative management associated with high morbidity and mortality.</p> Aims <p>We present a case of Bouveret syndrome in an elderly female patient, treated successfully by endoscopic intervention and aimed to review the literature assessing current evidence supporting non-operative management of this clinically challenging condition. </p> Methods <p>A literature search was performed using Medline® and Embase® databases and articles reviewed using Covidence® review software. Articles were screened using inclusion and exclusion criteria.</p> Results <p>125 cases met criteria for inclusion. Of these, 56% (70 cases) were over the age of 70. In 69 cases (55%), management was endoscopic intervention only. Mortality rate in those who were managed entirely endoscopically was lower compared to those who were subsequently managed operatively (3.6% vs 7.1%, respectively).</p> Conclusion <p>Bouveret syndrome poses substantial clinical challenges in frail, co-morbid patients, in whom surgical intervention carries significant risks of morbidity and mortality. This case report and the supporting literature demonstrate that endoscopic intervention can provide effective definitive treatment in carefully selected patients, mitigating the physiological burdens of operative management. It should therefore be considered as a first-line approach in high-risk individuals.</p>

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Rock and roll in the duodenum- endoscopic management of Bouveret syndrome: a case report and a review of the literature

  • 期刊论文

  • 发表日期：

    2026年4月6日

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  • Anna Murray,
  • Dorothy Johnston,
  • Lauren Thompson,
  • John Eccles,
  • Anthony McBrearty

摘要

Background

Bouveret syndrome is a rare presentation of gastric outlet obstruction secondary to a gallstone impacted at the duodenal bulb. The disease usually occurs in elderly females, often frail with operative management associated with high morbidity and mortality.

Aims

We present a case of Bouveret syndrome in an elderly female patient, treated successfully by endoscopic intervention and aimed to review the literature assessing current evidence supporting non-operative management of this clinically challenging condition.

Methods

A literature search was performed using Medline® and Embase® databases and articles reviewed using Covidence® review software. Articles were screened using inclusion and exclusion criteria.

Results

125 cases met criteria for inclusion. Of these, 56% (70 cases) were over the age of 70. In 69 cases (55%), management was endoscopic intervention only. Mortality rate in those who were managed entirely endoscopically was lower compared to those who were subsequently managed operatively (3.6% vs 7.1%, respectively).

Conclusion

Bouveret syndrome poses substantial clinical challenges in frail, co-morbid patients, in whom surgical intervention carries significant risks of morbidity and mortality. This case report and the supporting literature demonstrate that endoscopic intervention can provide effective definitive treatment in carefully selected patients, mitigating the physiological burdens of operative management. It should therefore be considered as a first-line approach in high-risk individuals.