Bouver syndrome refers to the repeated episodes of biliary tract inflammation, which leads to adhesions with adjacent structures such as the duodenum, hepatic flexure of the colon, stomach, and the biliary tract itself. Gallstones may become impacted, obstructing and compressing these areas, followed by secondary bacterial infections. This increases intra-biliary pressure, impairs local blood circulation, and may cause necrosis or perforation, resulting in fistula formation into the adhered organs. If gallstones obstruct the intestinal tract, this condition can occur. The syndrome is rare, accounting for approximately 1–3% of mechanical small intestine obstructions.

bubble_chart Clinical Manifestations

The main manifestations include persistent pain in the upper abdomen, which may have paroxysmal exacerbations, frequent fever, chills, and vomiting. The vomitus is yellow or grass-green liquid and may resemble coffee grounds. The abdomen is soft, with obvious abdominal distension and fullness. Murphy's sign is often positive, and there may be muscle tension or rebound tenderness, with a significant increase in white blood cells.

bubble_chart Diagnosis

The key to diagnosing this condition lies in maintaining high vigilance. For middle-aged and elderly women with obesity who present with acute non-strangulated intestinal obstruction, this disease should be considered. Abdominal X-rays should be performed, paying attention to tree-like or Y-shaped gas accumulation in areas such as the hepatic portal and bile ducts. Barium contrast studies of the digestive tract or barium enemas may reveal signs of barium reflux into the bile ducts. Early diagnosis can be made through B-ultrasound, ERCP, or CT scans.

The main treatment is surgery.