Bouveret's syndrome complicated by distal gallstone ileus after laser lithotropsy using Holmium: YAG laser

BACKGROUND: Bouveret's syndrome is an unusual presentation of duodenal obstruction caused by the passage of a large gallstone through a cholecystoduodenal fistula. Endoscopic therapy has been used as first-line treatment, especially in patients with high surgical risk. CASE PRESENTATION: We report a 67-year-old woman who underwent an endoscopic attempt to fragment and retrieve a duodenal stone using a Holmium: Yttrium-Aluminum-Garnet Laser (Ho:YAG) which resulted in small bowel obstruction. The patient successfully underwent enterolithotomy without cholecystectomy or closure of the fistula. CONCLUSION: We conclude that, distal gallstone obstruction, due to migration of partially fragmented stones, can occur as a possible complication of laser lithotripsy treatment of Bouveret's syndrome and might require urgent enterolithotomy

Damage behavior of air-plasma-sprayed thermal barrier coatings under foreign object impact

How do thermal barrier coatings react to the impact of a foreign object? The authors examined the damage done by a projectile to an air‐plasma‐sprayed coating system. Apart from permanent deformation, chipping of the ceramic top coat around the impression sites occurs at impact velocities above 150 m s–1. At increasing impact speed, the cracks in the top coat tend to elongate and result in coating removal (see Figure for a cross‐section)