Cholecystoduodenocolic fistula and gallstone ileus

Gibbons, C.P.; Ross, Bryan

doi:10.1136/pgmj.60.708.698

Cited by 10 publications

(11 citation statements)

References 6 publications

(8 reference statements)

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“…In the cases of the existence of a gallstone ileus, these patients also present signs of intestinal occlusion. [10] Despite this fact, the majority of the studies published in the medical literature suggest that, the most frequent symptom of patients with internal biliary fistula is actually diarrhea. This is due to the laxative effect of bile acids.…”

Section: Discussionmentioning

confidence: 99%

Gallstone Ileus Caused by a Cholecysto-Duodeno-Colic Fistula, Case Report And Literature Review

Suciu

Hălmaciu

Vunvulea

et al. 2017

ARS Medica Tomitana

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Introduction:Complex cholecysto-duodeno-colic fistulas are an extremely rare complication that can occur in patients with cholelithiasis. The aim of this article is to present the case of a pacient with cholecystoduodeno-colic fistula manifested with biliary ileus in a patient known for many years with cholelithiasis. Case report: We present the case of a 62 y/o male that was admitted in our clinic with the diagnosis of gallstone ileus. Emergency surgical intervention was needed. Intraoperatively we discovered a cholecysto-duodenocolic fistula complicated with gallstone ileus. During the operation we practiced retrograde cholecystectomy, closure of the fistulous tract (duodenoraphy, coloraphy), enterotomy and extraction of the calculus located inside the small intestine. The postoperative evolution was favorable. Conclusions:Cholecysto-duodeno-colic fistulas complicated with gallstone ileus are an extremely rare complication that can occur in patients with gallstones. In case of the occurrence of gallstone ileus, the surgical treatment is an emergency, being the only therapeutic technique that can save the patient's life.

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Section: Discussionmentioning

confidence: 99%

Gallstone Ileus Caused by a Cholecysto-Duodeno-Colic Fistula, Case Report And Literature Review

Suciu

Hălmaciu

Vunvulea

et al. 2017

ARS Medica Tomitana

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“…The factors favoring the fistula formation are: size of the gallstone, long history of biliary disease, reported episodes of acute cholecystitis, female sex and advanced age. Cholecystoduodenocolic fistulas are extremely rare, with only 25 cases reported [5,6,[16][17][18][19][20][21][22]. Twenty-three of these fistulas have resulted from penetrated gallstones; one was secondary to duodenal ulcer disease, and another one due to GBC.…”

Section: Discussionmentioning

confidence: 99%

Cholecystoduodenocolic Fistula by Gallbladder Carcinoma that Presenting as Bouveret's Syndrome: Case Report and Review of the Literature

Cianci¹,

Ambrosi²,

Fersini³

et al. 2014

Int J Gastroenterol Disord Ther

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We describe the first case in the literature of Bouveret's syndrome as the result of a cholecystoduodenocolic fistula secondary to gallbladder carcinoma. A 67-years-old woman was admitted to our department presenting with complaints of severe cramping abdominal pain, localized predominantly in the right hypochondrium and epigastrium, with infrequent alimentary and biliary vomiting for about three months. Based on the radiological and endoscopic findings, the provisional diagnosis of Bouveret's syndrome in a patient with cholecystoduodenal fistula and history of cholelithiasis was made. The laparotomy showed the presence of the stone in the duodenal bulb, already seen at endoscopy, and adhesions between gallbladder, superior duodenal flexure and hepatic flexure of the colon, and this inflammatory gangue strethed up to the hepatic hilum. During dissection in addition to the communication between the gallbladder and the duodenum, another fistula was found that led from the gallbladder to the colon. The suspicion of malignancy of this multiple biliary enteric fistula was confirmed by intraoperative frozen sections that revealed the precence of a poorly differentiated carcinoma of biliary-pancreatic origin, but the ultimate diagnosis of gallbladder carcinoma was made exclusively after the definitive histopathological examination. For these reasons the surgical procedure involved cholecystectomy with resection of the regional lymph nodes, gastrotomy with extraction of gallstone, trans-mesocolic Roux-en-Y gastro-jejunal mechanical anastomosis, resection of the hepatic flexure of the colon with termino-lateral colo-colic mechanical anastomosis. It's important to remember that rarely the Bouveret's syndrome can hide multiple biliary enteric fistulas or even a malignancy. We believe, in the light of our experience, that the surgical approach represents the first choice in the treatment of this serious disease.

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“…On the other hand, biliary‐enteric fistula may be overshadowed by other more dramatic manifestations of biliary tract disease such as acute cholecystitis, cholangitis, pancreatitis or intestinal obstruction due to gallstone ileus [1, 2]. Cholecystocolic fistula can cause severe diarrhoea [6]. The diagnosis of biliary‐enteric fistula is suggested by air in the biliary tree, which is present in as many as 50% of patients [5].…”

Section: Discussionmentioning

confidence: 99%

“…General principles of treatment are: to establish the anatomy and cause of the fistula, control infection, eliminate underlying biliary obstruction, correct electrolyte abnormalities and operate after bowel preparation [7]. The surgical treatment of choice of biliary‐enteric fistula is cholecystectomy, disconnection of the fistula and closure of the bowel [6].…”

Section: Discussionmentioning

confidence: 99%