¨A síndrome de Bouveret é uma forma rara de ileus biliar, em que a obstrução ocorre a nível duodenal. A raridade desta síndrome, associada a manifestações clínicas inespecíficas, contribui para que esta síndrome permaneça um importante desafio diagnóstico. Os sintomas clínicos não são específicos e é mais comumente apresentado com náuseas, vômitos, saciedade precoce e dor abdominal. A dor abdominal, as náuseas e os vómitos pós-prandiais de início súbito são os sintomas mais frequentes. Os achados radiológicos típicos compreendem a tríade de Rigler [presença de obstrução do intestino delgado e dilatação do estômago, pneumobilia (ar na árvore biliar) e cálculos ectópicos], que pode ser detectada em radiografias abdominais simples ou tomografia computadorizada abdominal, mas nem sempre está presente . A tomografia computadorizada também pode demonstrar a presença de fístula colecisteto-duodenal administrando material de contraste oral ou aéreo. A remoção do cálculos baixos impactados através da enterotomia ou gastrotomia ou litotripsia endoscópica é o tratamento usual. Em particular, as opções de tratamento não cirúrgico incluem litotripsia endoscópica mecânica, eletrohidráulica ou a laser e litotripsia de onda de choque extracorpórea, isoladas ou combinadas. No entanto, existe a possibilidade de migração distal de fragmentos, o que pode causar íleo distal e eventualmente requer remoção cirúrgica¨
■ Bouveret syndrome: current management strategies
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■ Bouveret´s syndrome – a rare form of gallstone ileus causing death: appearance on post-mortem CT and MRI
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■ Bouveret´s syndrome – a rare form of gallstone ileus causing death: appearance on post-mortem CT and MRI
S G Bruni, M Pickup, D Thorpe
BJRI Case Reports 2017, vol 3 (3)
http://www.birpublications.org/doi/full/10.1259/bjrcr.20170032
■ Bouveret syndrome
H Su, M Tsai
QJM: An International Jounal of Medicine jan 2018
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■ Gallstone ileus, clinical presentation, diagnostic and treatmen approach
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■ Uncommon presentation of a common disease – Bouveret´s syndrome: a case report and systematic literature review
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■ Successful endoscopic treatment of Bouveret syndrome in a patient with choledochoduodenal fistula complicating duodenal ulcer
Syed Hasan, Zubair Khan, Umar Darr et al
Case Rep Gastrointest Med. 2017; 2017: 6918905
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■ A case of Bouveret´s syndrome treated with gastrojejunal anastomosis
I D Kostakis, Z Garoufalia, T Feretis et al
Journal of Surgical Reports 2017, vol 10
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■ Uncommon presentation of a common disease – Bouveret´s syndrome: a case report and systematic literatures review
Yahya AL-Habbal, Matthew Ng, David Bird, et al
World J Gastrointest Surg. 2017 Jan 27; 9(1): 25–36
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5237820/
■ Manejo endoscópico de una paciente de edad avanzada con síndrome de Bouveret
Povar Echeverría, M., Boudet Barraca, J.M. and Auquilla Clavijo, P.E.
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■ The Bouveret´s syndrome: a case report of a rolling gallstone from the gallbladder to the duodenum
M Di Serafino, R Severino, R Rocca, D Maroscia
Open Journal of Radiology 2016, vol 6: 68-72
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■ A rare presentation of gallstones: Bouveret’s syndrome, a case report.
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■ Primer caso publicado de síndrome de Bouveret asociado a perforación duodenal y vesicular al retroperitoneo.
Vieiro-Medina, María Victoria et al
Rev. esp. enferm. dig., June 2016, vol.108, no.6, p.376-378
■ A rare presentation of gastric outlet obstruction (G))) – The Bouveret´s syndrome
D S Kalwaniya, S Guha, M Kuppuswamy et al
Annals of Medicine & Surgery 2015, vol 4 (1): 67-71
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■ Laparoscopic management of Bourveret syndrome
Richard Charles Newton, Sofronis Loizides, Nicholas Penney, Krishna Kumar Singh
BMJ Case Rep. 2015; 2015: bcr2015209869
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4420823/
■ Bouveret´s syndrome: an overlooked diagnosis. A case report and review of literature
Ghazi Raji Qasaimeh, Sohail Bakkar, Khaled Jadallah
Int Surg. 2014 Nov-Dec; 99(6): 819–823
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254246/
■ Bouveret´s syndrome with severe esophagitis and a purulent fistula
R Bonam, z Vahora, G Harvin, W Leland
ACG Case Reports 2014, vol 1 (3)
https://acgcasereports.gi.org/bouverets-syndrome-with-severe-esophagitis-and-a-purulent-fistula/
■ Síndrome de Bouveret como forma de apresentação de doença de Crohn: relato de uma associação rara.
Ribeiro, Iolanda et al.
J Port Gastrenterol., Jul 2013, vol.20, no.4, p.167-171
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■ Gastric outlet obstruction in a patient with Bouveret´s syndrome: a case report
Celso Nabais, Raquel Salústio, Inês Morujão et AL
BMC Res Notes. 2013; 6: 195
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■ Sindrome de Bouveret (Obstrucción gástrica o duodenal por una litiasis biliar).
Melero, Marcelo J. et al.
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■ Íleo biliar y síndrome de Bouveret. Lo mismo pero distinto: Descripción de dos casos y revisión de la literatura
Álvarez Chica, Luis Fernando, Bejarano Cuéllar, Walter and Rojas Cardozo, Olga Lucía
Rev Col Gastroenterol, Mar 2010, vol.25, no.1, p.86-9
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■ Síndrome de Bouveret: Resolución endóscopica y quirúrgica de cuatro casos clínicos
Iñíguez, Armando et al.
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■ Successful endoscopic management of Bouveret´s syndrome in a patient with cholecystoduodenocolic fistulae
- Tanwar, A. Mawas, M. Tutton, D. O’Riordan
Case Rep Gastroenterol. 2008 Sep-Dec; 2(3): 346–350
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3075195/
■ Bouveret´s syndrome: a case report
Daniel J Warren, Robert J Peck, Ali W Majeed
J Radiol Case Rep. 2008; 2(4): 14–17
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3303235/
■ Bouveret´s syndrome as an unusual cause of gastric outlet obstruction: a case report
Deepak Joshi, Ali Vosough, Tom M Raymond, Chris Fox, Arun Dhiman
J Med Case Reports. 2007; 1: 73
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2034582/
■ Bouveret´s syndrome: revising gallstone obstruction of he duodenum
Dilip Dan, Don W. Collure, Eddie L. Hoover
J Natl Med Assoc. 2003 Oct; 95(10): 969–973.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594488/
■ by Dr Paulo Fernando Leite
Cardiologia – Centro Médico Unimed BH
Rua Gonçalves Dias 202
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Email: pfleite1873@gmail.com