Fig. 5

Bouveret syndrome. CT coronal reformation (a) shows marked gastric dilatation (asterisks) caused by a round lesion at the duodenal bulb (arrowhead); there is also densification and indefinition of the contour of the gallbladder (arrow). Unenhanced CT (b) shows the lesion is spontaneously hyperdense-endoluminal gallstone at the duodenal bulb (arrowhead). A small fistulous tract filled with air (c) (arrowhead) is seen between the duodenal bulb and the expected location of the gallbladder, which had ruptured and formed a phlegmon (arrow)