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Bouveret's syndrome is a rare disorder that causes upper gastrointestinal obstruction, typically in elderly patients with a history of chronic cholelithiasis. We present an unusual case of a 58-year-old woman with untreated vesicular lithiasis who developed Bouveret's syndrome. She presented with severe abdominal pain, nausea, vomiting, and abdominal distension.

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A woman in her early 90s presented to the acute surgical take with a 3-day history of worsening reflux, vomiting, epigastric pain and constipation. Subsequent imaging demonstrated two large, impacted gallstones in the pylorus and proximal jejunum secondary to a cholecystoduodenal fistula. A diagnosis of Bouveret syndrome was made, and endoscopic attempts to break down and remove the stones were unsuccessful.

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Bouveret's syndrome is a rare form of bowel obstruction caused by the impaction of a large gallstone through a cholecystoduodenal fistula, leading to gastric outlet obstruction. This article aims to highlight the clinical presentation and management of this syndrome, given its low incidence and high mortality rate of 12% to 30%. We present the case of an 83-year-old patient with a history of diabetes and hypertension who presented with abdominal pain, distension, and vomiting.

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