{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:48:05Z","timestamp":1771019285457,"version":"3.50.1"},"reference-count":4,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,12]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>A woman in her early 90s presented to the acute surgical take with a 3-day history of worsening reflux, vomiting, epigastric pain and constipation. Subsequent imaging demonstrated two large, impacted gallstones in the pylorus and proximal jejunum secondary to a cholecystoduodenal fistula. A diagnosis of Bouveret syndrome was made, and endoscopic attempts to break down and remove the stones were unsuccessful. The stones were left in the stomach, with a pigtail stent placed through the fistula between the stomach and gallbladder to prevent the stones impacting again and to allow adequate drainage of the gallbladder to prevent further flare-ups. Due to the patient\u2019s comorbidities, it was decided to leave the stent in situ long term as opposed to surgical management. This has shown to be successful in follow-up. Our case highlights that Bouveret syndrome can potentially be managed conservatively long term in patients deemed unfit for major surgical intervention.<\/jats:p>","DOI":"10.1136\/bcr-2024-261558","type":"journal-article","created":{"date-parts":[[2024,12,15]],"date-time":"2024-12-15T20:30:48Z","timestamp":1734294648000},"page":"e261558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Bouveret syndrome managed conservatively with the insertion of a double pigtail stent between the stomach and the gallbladder"],"prefix":"10.1136","volume":"17","author":[{"given":"Joshua","family":"Garg","sequence":"first","affiliation":[{"name":"ENT, UHB, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Wiggins","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Sahloul","sequence":"additional","affiliation":[{"name":"General Surgery, UHB, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,15]]},"reference":[{"key":"2025082708452254000_17.12.e261558.1","article-title":"Bouveret syndrome-the rarest variant of gallstone ileus: a case report and literature review","volume":"2013","author":"Mavroeidis","year":"2013","journal-title":"Case Rep Surg"},{"key":"2025082708452254000_17.12.e261558.2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13244-019-0825-4","article-title":"Gallstones top to toe: what the radiologist needs to know","volume":"11","author":"Murphy","year":"2020","journal-title":"Insights Imaging"},{"key":"2025082708452254000_17.12.e261558.3","doi-asserted-by":"crossref","DOI":"10.14309\/crj.0000000000001051","article-title":"Endoscopic Management of Bouveret Syndrome With Electrohydraulic Lithotripsy","volume":"10","author":"Wang","year":"2023","journal-title":"ACG Case Rep J"},{"key":"2025082708452254000_17.12.e261558.4","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1007\/BF02653271","article-title":"A temporary endoscopic solution that significantly improves the prognosis of Bouveret\u2019s syndrome","volume":"5","author":"Vigneri","year":"1991","journal-title":"Surg Endosc"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:45:29Z","timestamp":1756309529000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":4,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,15]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-261558"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261558","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}