The clinical and radiological features of cholecystocolic fistulae

Abstract

The clinical and radiological features of seven patients presenting with cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43-85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinical course. Diarrhoea was the most common presenting symptom and the typical clinical features of gallbladder disease were absent. Cholangitis occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). In only one patient was the diagnosis of biliary-intestinal fistula suspected on the basis of the plain abdominal radiograph (Case 5). A diagnosis of cholecystocolic fistula was established by barium enema (5 cases), endoscopic retrograde cholangiopancreatography (ERCP) (1 case) and diagnostic laparotomy (1 case). The only cause identified in this series was acute or chronic cholecystitis.

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

“…[14] Another important fact to take into account is the direct communication between the bile ducts and the intestinal tract that can lead to an infectious syndrome due to the occurrence of angiocholitis. [15] The positive diagnosis in such case is very difficult to establish preoperative. Radiological examination is usually inconclusive, being able only to highlight signs of intestinal occlusion or the existence of a gallstone, if the latter is radiopaque.…”

“…For this reason, a frozen section becomes very useful. [7] It is usually very difficult to diagnose such pathologies preoperative. Nowadays with the development of the imagistic techniques it is possible in some cases to diagnose preoperative a gallstone ileus, usually this diagnosis being set during the surgical intervention itself.…”

Fístula colecistocólica: una causa poco frecuente de hemorragia digestiva baja

“…35, Nº 3, septiembre-diciembre intRoducciÓn La fístula colecistocólica es un tipo poco frecuente de fístula bilioentérica que tiene una presentación clínica variable y que aparece en la mayoría de los casos como una rara complicación de la enfermedad litiásica biliar. Se ha descrito una mayor incidencia en personas de edad avanzada y con comorbilidad asociada 1 . Puede manifestarse en forma de dolor abdominal, nauseas, 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.…”

Arrosionsblutung der A. cystica bei cholezysto-kolischer Fistel als seltene Ursache einer akuten gastrointestinalen Blutung

“…Die Häufigkeit spontaner bilio-enterischer Fisteln wird mit zwischen 0,2 und 0,5 % aller Autopsien und zwischen 1,2 und 5 % aller Patienten mit Operationen am biliären System angegeben[7,10,12,18,25]. Bei der überwiegenden Mehrheit der betroffenen Patienten entwickeln sich die Fisteln als Folge von Cholezystitiden bei Steinleiden[11,18]. Weitere Ursachen sind Abdominaltraumata, Morbus Crohn und Malignome des biliären Traktes, des Pankreaskopfes und des Darmes und atypische Infektionen wie z.…”

“…Weitere Ursachen sind Abdominaltraumata, Morbus Crohn und Malignome des biliären Traktes, des Pankreaskopfes und des Darmes und atypische Infektionen wie z. B. Aktinomykosis, Tuberkulose oder Echinokokkose, bei bilio-duodenalen Fisteln auch peptische Ulzera[1,11]. Aufgrund der engen Lagebeziehung handelt es sich bei 50-80 % der Gallefisteln um Fisteln zum Duodenum.…”