Bouveret’s syndrome is an uncommon form of gallstone ileus that is characterized by a gastric outlet obstruction caused by impaction of a gallstone in the pylorus or proximal duodenum after its passage through a cholecystoduodenal fistula.
Patients with gallstone ileus may present with radiographic findings of Rigler’s triad (i.e., pneumobilia, small-bowel obstruction, and an ectopic gallstone).
Mechanical lithotripsy with endoscopic removal of the stone was attempted in the patient (Panel B); however, the procedure was unsuccessful and was complicated by a perforation of the proximal duodenum.在患者（Panel B）中尝试内镜下机械碎石术后取石；然而，手术失败，并造成了十二指肠近端穿孔。
The patient then underwent an open laparotomy for repair of the duodenal perforation and removal of a mixed gallstone, which measured 4.4 cm in the greatest dimension (Panel C).
She had complete resolution of symptoms and was discharged home 15 days after admission.