The present study aimed to describe the diagnosis and surgical management of Bouveret syndrome, an uncommon cause of intestinal obstruction. We report a case of a 74-year-old woman presenting with clinical features consistent with intestinal obstruction, in whom clinical evaluation, laboratory tests, and contrast-enhanced abdominopelvic computed tomography were performed to establish the diagnosis. Surgical treatment was subsequently carried out by exploratory laparotomy and enterotomy for gallstone extraction. Computed tomography revealed pneumobilia and the presence of an ectopic gallstone associated with intestinal obstruction, findings consistent with Rigler’s triad. Laparotomy with stone extraction and primary closure was performed without cholecystectomy. The patient had a favorable postoperative course, with restoration of bowel function and no immediate complications. Bouveret syndrome should be considered in elderly patients presenting with intestinal obstruction and a history of cholelithiasis. Computed tomography is essential for diagnosis, and surgical management represents a safe and definitive option when endoscopic treatment is not feasible or has failed.
Fonseca et al. (2026) studied this question.