Bouveret syndrome: an infrequent presentation of gallstone ileus.

We report the case of a 75-year-old woman with a personal background of hypertension and peptic ulcer with a 5-days history of constipation, vomiting and abdominal pain. Simple radiology and abdominal computed tomography were performed, finding a great dilatation of the stomach until the first portion of the duodenum. The obstruction was due to a gallstone obstruction in the second portion of the duodenum (Fig. 1). The patient underwent emergency laparotomy. A gastric dilatation and an inflammatory plastron in the duodenum were found. Duodenotomy (Fig. 2) and gallstone removal was performed (Fig. 3). No surgery over the gallbladder or the fistula was performed.