Massive lower gastrointestinal hemorrhage from cholecystocolic fistula

Kaplan, Bernard J.

doi:10.1007/bf02617178

Cited by 20 publications

(7 citation statements)

References 5 publications

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“…We identified 160 articles from 1950 to 2006 concerning 231 cases of CCF, which are the object of our review []. The analysis of diagnostic imaging and treatment is mainly focused on present tools, as proposed in recent papers.…”

Section: Methodsmentioning

confidence: 99%

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Cholecystocolonic fistula: facts and myths. A review of the 231 published cases

Costi

Randone

Violi

et al. 2008

J Hepatobiliary Pancreat Surg

129

172

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Background Cholecystocolonic fistula (CCF) is the second most common cholecystoenteric fistula and is often discovered intraoperatively, resulting in a challenging situation for the surgeon, who is forced to switch to a complex procedure, often in old, unfit patients. Management of this uncommon but possible finding is still ill defined. Methods An extensive review of 160 articles published from 1950 to 2006 concerning 231 cases of CCF was performed.Results CCF is mostly an affliction of women in their sixth to seventh decades and is rarely diagnosed preoperatively. Chronic diarrhea is the key symptom in nonemergency patients, but, in one-fourth of cases, CCF presents with an acute onset, mostly biliary ileus. In onefourth of patients, a second hepatobiliary abnormality is present, including gallbladder cancer in 2% of cases. In uncomplicated cases, diverting colostomy is not performed anymore, and laparoscopy treatment has been described in specialized centers. Symptomatic treatment of concomitant biliary ileus (without treating CCF) is a feasible option.Resolution of colonic biliary ileus by interventional endoscopy is reported. Conclusion CCF should be considered in differential diagnosis of diarrhea, especially in old, female patients. A possible second hepatobiliary abnormality should be always investigated. Extemporaneous frozen section should be performed if gallbladder cancer is suspected. Depending on clinical presentation, different treatments for CCF are indicated, ranging from minimally invasive procedures to extensive resection.

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Section: Methodsmentioning

confidence: 99%

“…CBD [11], [18], [21], [23], [50], [52], [58], [63], [68], [69], [70], [73], [75], [76], [82], [83], [88], [89], [95], [96], [102], [103], [106], [113], [117], [119], [120], [125], [133], [140], [142], [143], [147], [149], [150], [153], [157], [159] Massive bleeding 14 [17], [20], [28][29][30][31], [36], [51], [81], [97], [139], [144], [148],…”

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Cholecystocolonic fistula: facts and myths. A review of the 231 published cases

Costi

Randone

Violi

et al. 2008

J Hepatobiliary Pancreat Surg

129

172

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“…Así mismo estos ácidos biliares cuando llegan al colon irritan la mucosa provocando diarrea secretora, con importante pérdida de agua y electrolitos 7 . Otras presentaciones menos frecuentes de esta entidad son la hemorragia digestiva baja [8][9][10][11] , como en el caso que aquí se describe, colangitis de repetición o más raramente como un ileo biliar 12 .…”

Section: Discussionunclassified

Fístula colecistocólica: una causa poco frecuente de hemorragia digestiva baja

Ostiz

Vila

Sanchotena

et al. 2012

Anales Sis San Navarra

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ResuMenLa fístula colecistocólica es un tipo poco común de fístula bilioentérica que tiene una presentación clínica variable y que generalmente aparece como complicación de la enfermedad litiásica biliar. Puede manifestarse en forma de dolor abdominal, náuseas, pérdida de peso, diarrea con o sin esteatorrea asociada, clínica dispéptica y más raramente como hemorragia digestiva baja, colangitis de repetición o incluso como un ileo biliar. Las técnicas más útiles para el diagnóstico son el TC abdominal, los estudios baritados y la colangiopancreatografía retrógrada endoscópica (CPRE).Describimos el caso de una mujer de edad avanzada, pluripatológica, con fístula colecistocólica, que se presentó en forma de hemorragia digestiva baja. Fue estudiada mediante colonoscopia, TC abdominal y enema de bario. Durante el ingreso requirió transfusión de 4 concentrados de hematíes, desestimándose el tratamiento invasivo debido a su comorbilidad de base. Evolucionó favorablemente, con resolución espontanea del cuadro. Dos meses después permanecía asintomática.Palabras clave. Fístula colecistocólica. Hemorragia digestiva baja. aBstRactCholecystocolic fistula is an uncommon biliaryenteric fistula with a variable clinical presentation that usually appears as a rare complication of gallstone disease. It can present with abdominal pain, nausea, weight loss, diarrhoea with or without associated steatorrhea, and dyspeptic symptoms. Rare cases have been reported with lower gastrointestinal haemorrhage and even with a gallstone ileous. The most useful techniques for diagnosis are CT, barium studies, and ERCP.We report a case of a cholecistocolic fistula in an eldery woman with multiple medical comorbidities that presented as lower gastrointestinal bleeding. She was explored with colonoscopy, abdominal CT and barium enema. She required a total of 4 units of whole blood and because of her comorbidities a decision was made not to proceed with invasive treatment. She had a good evolution and was asymptomatic two months later.

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“…Internal biliary fistulae most commonly result from calculus cholecystitis,[1] but can also occur occasionally following carcinoma of the gallbladder where the necrotic tumour perforates into the adjacent duodenum or colon, or both. [2] The cholecystocolic fistulae account for up to one-fifth of all fistulae, and are second in frequency to those involving the duodenum.…”

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confidence: 99%

Cholecystocolic fistula secondary to gallbladder carcinoma: A rare case

Rastogi

2008

Saudi J Gastroenterol

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Internal biliary fistulae are a well-recognized complication of biliary lithiasis. Among these, the cholecystoduodenal fistulae are the commonest while cholecystocolic fistulae (CCF) occur much less frequently. CCF secondary to gallbladder carcinoma is a rare occurrence and has been reported in very few studies. Here, the author reports a case of cholecystocolic fistula secondary to gallbladder carcinoma. Preoperative diagnosis of this condition requires high index of suspicion and is usually difficult. Computed tomography scan is helpful in establishing a preoperative diagnosis.

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Massive lower gastrointestinal hemorrhage from cholecystocolic fistula

Cited by 20 publications

References 5 publications

Cholecystocolonic fistula: facts and myths. A review of the 231 published cases

Cholecystocolonic fistula: facts and myths. A review of the 231 published cases

Fístula colecistocólica: una causa poco frecuente de hemorragia digestiva baja

Cholecystocolic fistula secondary to gallbladder carcinoma: A rare case

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