The clinical and radiological features of spontaneous internal biliary fistulæ

Pitman, R. G.; Davies, Alan

doi:10.1002/bjs.18005022212

Cited by 17 publications

(5 citation statements)

References 12 publications

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“…A similar case in which reflux of barium from duodenum to common bile duct was demonstrated has been reported by Cook, Hou, Ho, and McFadzean (1954). Other examples of biliary gas due to an incompetent sphincter of Oddi have been described by Pitman and Davies (1963).…”

Section: Associated Aetiological Factorssupporting

confidence: 60%

A fresh approach to the pathogenesis of pancreatitis.

McCutcheon¹

1968

Gut

129

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Section: Associated Aetiological Factorssupporting

confidence: 60%

A fresh approach to the pathogenesis of pancreatitis.

McCutcheon¹

1968

Gut

129

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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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“…Simple enterolithotomy may then be life-saving, leaving the option for later re-exploration. Indeed, re-exploration may prove unnecessary, for in the two reported cases where simple enterolithotomy has been performed, no reexploration was required, the fistula closing spontaneously within 10 days in one (Doromal et al, 1975), and remaining patent but asymptomatic for at least five months in the other (Pitman and Davies, 1963).…”

Section: Case Reportmentioning

confidence: 99%

“…However, a double communication between the gallbladder and both the duodenum and colon is rare in this condition, only four previous cases having been recorded in the English language (Doromal, Estacio and Sherman, 1975;Dowse, 1963;Pitman and Davies, 1963;Shocket, Evans and Jones, 1970). A further case is presented here.…”

Section: Introductionmentioning

confidence: 97%