Paciente de 78 años con antecedentes de HTA, osteoporosis, nefrectomía y prótesis que acudió a Urgencias por vómitos y dolor abdominal. En la analítica se observó elevación de enzimas de colestasis y una PCR de 7. El TC toracoabdominal (fig. 1) y la gastroscopia (fig. 2) observaron una imagen endoluminal a nivel de la segunda porción del duodeno que correspondía a un cálculo biliar migrado oclusivo (síndrome de Bouveret). Ante la imposibilidad de su extracción se indicó la cirugía urgente (fig. 3).
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