Bouveret syndrome management

A 78-year-old patient with a history of hypertension, osteoporosis, nephrectomy, and prosthesis attending the emergency department with vomiting and abdominal pain. Thoracoabdominal CT scan (Fig. 1) and gastroscopy (Fig. 2) showed an endoluminal image at the level of the second portion of the duodenum corresponding to an occlusive gallstone migration (Bouveret syndrome). As it was impossible to remove it, emergency surgery was indicated (Fig. 3).

Fig. 1

Fig. 2

Fig. 3