Bouveret’s syndrome: a report of two cases

Introduction: Bouveret’s syndrome, a rare and clinically challenging condition, is a variant of gall stone ileus caused by impaction of a large gallbladder stone in the duodenum secondary to a cholecystoduodenal fistula. Case presentation: We present two cases of duodenal obstruction in old patients due to gall stone migration and impaction in the duodenum. Both were treated surgically. Discussion: Bouveret’s syndrome is a rare variant of gall stone ileus. Risk factors include old age, female sex, large-sized stones, and long history of gall stone disease. Treatment options include extracorporeal shock wave lithotripsy, endoscopy, and surgery. Conclusion: Bouveret’s syndrome is a clinically challenging diagnosis to make. Although surgical stone extraction remains the classic treatment option with the least failure rates, leaving the fistula alone is associated with the least morbidity and mortality rates.