Bouveret's disease and thrombosed aortic aneurysm presenting as fall in an octogenarian with multimorbidity: A case report with a therapeutic impasse

Abstract

We present the case of an octogenarian patient with multimorbidity, who presented with Bouveret's disease and a thrombosed aortic aneurysm, revealed by a fall. Following the fall, she exhibited confusion, refusal to eat, and episodes of paroxysmal tachycardia.

The diagnosis of Bouveret's disease was established based on ECG findings. However, therapeutic options were limited due to the patient's comorbidities. Radiofrequency ablation, the gold standard treatment for Bouveret's disease, was not available in our setting. The treatment plan included a beta-blocker and anticoagulation with vitamin K antagonists, despite poor control of paroxysmal tachycardia.

This clinical case highlights the complexity of diagnosis and management of Bouveret's disease in elderly patients with multimorbidity. Atypical presentation, the presence of comorbidities, and limited access to advanced treatments pose significant challenges in managing this condition.