Bilioenteric fistules are fairly rare, cholecystoduodenal fistules are the commonest type, accounting for 70-80% of cases. Cholecystoduodenal fistules usually occur as a consequence of cholecystolithiasis and cholecystitis. Their symptomatology is atypical and fistules are frequently detected during surgery. Preoperative diagnostic procedures include visualization methods, such as US, CT, MRI, resp.ERCP. Both conventional laparotomy, as well as laparoscopy may be used in the treatment of the disease. Each of the methods has its pros and cons. The authors present a case review of a 85-year old female patient with a cholecystoduodenal fistule, diagnosed prior to the surgical procedure. Conventional laparotomy was elected as a method of treatment and the outcome was successful.
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Cureus
August 2024
General Surgery, Lewis Gale Medical Center, Salem, USA.
Cholelithiasis and its complications are among the most prevalent and costly medical conditions in the United States. Chronic gallbladder disease can progress into more complicated conditions, such as a cholecystoenteric fistula and, more specifically, a cholecystoduodenal fistula (CDF). Repair of these fistulas is complex and usually performed with an open approach.
View Article and Find Full Text PDFVideoGIE
February 2024
Department of Medicine, Division of Gastroenterology, Kingston Health Sciences Center, Queen's University, Kingston, Ontario, Canada.
Video 1Treatment of Bouveret syndrome with stone fragmentation using an endoscopic submucosal dissection knife. A 61-year-old man with a 3-decade history of recurrent cholecystitis presented to the community emergency department with severe right upper quadrant pain. A CT scan was performed and revealed gangrenous cholecystitis with likely cholecystoduodenal fistulous communication.
View Article and Find Full Text PDFCureus
June 2023
General Surgery, Hospital General de Zona 6, Instituto Mexicano del Seguro Social, San Nicolas de los Garza, MEX.
Biliary fistula is a rare (less than 8%) cholecystectomy complication, internal fistulae being the most common of them (mainly colonic and duodenal). However, the presence of two fistulas at the same time is extremely rare, with a small number of cases reported in the literature to date. Symptoms tend to be non-specific, leading to a difficult preoperative diagnosis.
View Article and Find Full Text PDFJ Surg Case Rep
June 2023
Department of Surgery, St. Joseph's University Medical Center, Paterson, NJ, USA.
Gallstone ileus is a rare cause of intestinal obstruction. Due to long-standing inflammation of the gallbladder, fistulization can occur within nearby structures, most commonly to the duodenum or hepatic flexure of the colon. Through these fistulas, a stone can migrate and result in a small bowel obstruction or a large bowel obstruction.
View Article and Find Full Text PDFJ Surg Case Rep
May 2023
Department of Surgery, NYU Langone Hospital-Long Island, Mineola, NY, USA.
Post-cholecystectomy syndrome (PCS) is a well-documented complication of incomplete cholecystectomy. The etiology is often post-surgical chronic inflammation from unresolved cholelithiasis, which is secondary to anatomical abnormalities, including a retained gallbladder or a large cystic duct remnant (CDR). An exceedingly rare consequence is retained gallstone fistulization into the gastrointestinal tract.
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