{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:40:09Z","timestamp":1756374009282,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Gallstones are common and largely asymptomatic, but can result in significant morbidity in a small proportion of patients. Choledochal-enteric fistulation is one such complication with an associated mortality of 15\u201318%. The authors present a case of an 88-year-old man admitted to the general medical ward with an acute upper gastrointestinal bleed. Oesophagogastroduodenoscopy found a large gallstone impacted in the pylorus and CT scan revealed a choledochal-duodenal fistula. At laparotomy it was found that a 6.2 cm gallstone had fistulated into D1 and the pylorus and impacted there, causing outflow obstruction \u2013 Bouveret\u2019s syndrome. A subtotal cholecystectomy was performed and the stone was removed by a separate gastrostomy. A radiological follow through study on day 14 showed contrast passing freely through the duodenum with no leak and the patient went on to make a slow, but uneventful recovery.<\/jats:p>","DOI":"10.1136\/bcr.05.2011.4275","type":"journal-article","created":{"date-parts":[[2011,12,2]],"date-time":"2011-12-02T19:40:52Z","timestamp":1322854852000},"page":"bcr0520114275","source":"Crossref","is-referenced-by-count":2,"title":["Choledochal-duodenal fistula presenting as an upper GI bleed"],"prefix":"10.1136","volume":"2011","author":[{"given":"Emma Lucy","family":"Marsdin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Kreckler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulhalim","family":"Alzein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horace","family":"D\u2019Costa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2011,12,1]]},"reference":[{"key":"2025082802060008000_2011.nov28_1.bcr0520114275.1","first-page":"441","article-title":"Gallstone ileus: a review of 1001 reported cases.","volume":"60","author":"Reisner","year":"1994","journal-title":"Am Surg"},{"key":"2025082802060008000_2011.nov28_1.bcr0520114275.2","first-page":"636","article-title":"Risk factors for gallbladder perforation.","volume":"82","author":"Roslyn","year":"1987","journal-title":"Am J Gastroenterol"},{"key":"2025082802060008000_2011.nov28_1.bcr0520114275.3","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800770707"},{"key":"2025082802060008000_2011.nov28_1.bcr0520114275.4","unstructured":"Bouveret L . Stenose de pyloroadherent a la vesicule calceuse. Rev Med 1896;16:1\u00e2\u0080\u009316."},{"key":"2025082802060008000_2011.nov28_1.bcr0520114275.5","first-page":"489","article-title":"[Gallstone ileus: results of analysis of a series of 40 patients].","volume":"24","author":"Rodr\u00c3\u00adquez Hermosa","year":"2001","journal-title":"Gastroenterol Hepatol"},{"key":"2025082802060008000_2011.nov28_1.bcr0520114275.6","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-826100"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.05.2011.4275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:06:10Z","timestamp":1756371970000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.05.2011.4275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,12,1]]},"references-count":6,"alternative-id":["10.1136\/bcr.05.2011.4275"],"URL":"https:\/\/doi.org\/10.1136\/bcr.05.2011.4275","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2011,12,1]]}}}