Bonam, RamiVahora, ZahidHarvin, GlennLeland, William2016-06-102016-06-102014-04ACG Case Reports Journal; 1:3 p. 158-1602326-3253http://hdl.handle.net/10342/5540Bouveret's syndrome is a rare variant of gallstone ileus with an overall incidence of 1–3%. It is a rare cause of gastric outlet obstruction resulting from the passage and impaction of a large gallstone through a cholecysto-duodenal fistula. A combination of diagnostic modalities is often required for a diagnosis. Management options include endoscopy and surgery. The most commonly performed procedures are enterolithotomy or gastrostomy, either alone or with cholecystectomy and fistula repair. We describe a unique variant of chronic Bouveret's syndrome with the unusual associations of severe esophagitis and a purulent fistula.Articlepmc443530010.14309/crj.2014.36