More than meets the eye: Subtle but important CT findings in Bouveret's syndrome

Gan, Susan, Roy-Choudhury, Shuvro, Agrawal, Sanjay, Kumar, Harish, Pallan, Arvind, Super, Paul and Richardson, Martin (2008) More than meets the eye: Subtle but important CT findings in Bouveret's syndrome. American Journal of Roentgenology, 191 1: 182-185. doi:10.2214/AJR.07.3418


Author Gan, Susan
Roy-Choudhury, Shuvro
Agrawal, Sanjay
Kumar, Harish
Pallan, Arvind
Super, Paul
Richardson, Martin
Title More than meets the eye: Subtle but important CT findings in Bouveret's syndrome
Journal name American Journal of Roentgenology   Check publisher's open access policy
ISSN 0361-803X
1546-3141
Publication date 2008-07
Sub-type Article (original research)
DOI 10.2214/AJR.07.3418
Open Access Status
Volume 191
Issue 1
Start page 182
End page 185
Total pages 4
Place of publication Leesburg, United States
Publisher American Roentgen Ray Society
Language eng
Formatted abstract
OBJECTIVE
Gallstones are a rare cause of duodenal or gastric outlet obstruction and therefore are not commonly suspected. Rigler's radiographic triad of pneumobilia, bowel obstruction, and an ectopic gallstone is seen in few of these patients. The symptoms are insidious and nonspecific, and the diagnosis is usually made radiologically. Although CT scans are far more sensitive, 25% of cases are still missed, often because the size of the offending gallstone is underestimated.

CONCLUSION
Better assessment of stone size, and therefore higher accuracy of diagnosis, could be achieved if attention is paid to more subtle but nonetheless important signs. These include compressed air in dependent areas of the duodenal lumen, an area of soft-tissue rather than fluid density surrounding the calcified rim of the stone, and a faint radiolucency in or beyond this soft-tissue area that could represent laminations of fat or air in the stone.
Keyword Bouveret's syndrome
CT
Gallstone ileus
Gastric outlet obstruction
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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