Biliodigestive fistulae and gallstone ileus: diagnostic and therapeutic considerations. Our experience

Comparative analysis of MDCT and MRI in diagnosing chronic gallstone perforation and ileus

“…Because the fistula is the direct and important sign to identify GSP for imaging technology preoperatively, and sometimes the perforation and fistulas may be complex [19], which include bile duct-intestine perforation, cholecysto-common bile duct perforation or even the above two or more perforation existed simultaneously. It is important to evaluate precisely the situation of perforation to avoid complex complication even mortality, besides considering the extent of intestinal obstruction and the size and location of ectopic stone.…”

Enterolithiasis

“…Typical pathogenesis of gallstone ileus begins with acute or chronic cholecystitis, often in the setting of cholelithiasis, which spreads inflammation and adhesion to the alimentary tract, leading to development of a biliary-enteric fistula. Given the anatomic proximity of the duodenal wall, cholecystoduodenal fistula accounts for overwhelming majority (86%-96%) of the tracts, followed by cholecysto-colonic, cholecysto-gastric, and choledocho-duodenal fistulas [33,34,57,[69][70][71][72][73][74] . Gallstones eventually enter the intestinal tract and may result in clinical obstruction with classic predilection to known areas of stasis in the physiologically narrower distal ileum and ileocecal valve (in 60% to 85% of the cases), proximal small intestine, stomach, and finally colon [34,37,38] .…”

Laparoscopic management of cholecystoduodenal fistula

“…До операции диа-гноз устанавливается менее чем в 50% наблюдений. При подозрении на ХДС наиболее информативным методом дооперационной диагностики является компьютерная томография с контрастным усилени-ем, позволяющая визуализировать патологическое соустье [2].…”