-
Cureus Nov 2021Cholecystoduodenal fistulas are a type of internal biliary fistula that occur due to chronic inflammation of the gallbladder/biliary tree; if left...
Cholecystoduodenal fistulas are a type of internal biliary fistula that occur due to chronic inflammation of the gallbladder/biliary tree; if left untreated, perforation and necrosis can occur. Cholecystoduodenal fistulas are often difficult to diagnose due to their non-specific signs and symptoms. Since the widespread use of techniques such as magnetic resonance cholangiopancreatography and imaging modalities such as computed tomography, the frequency of reports describing intraoperative cholecystoduodenal fistula has reduced dramatically. Here, we report the case of a 54-year-old female who presented with a two-day history of non-radiating epigastric abdominal pain, initially diagnosed with acute cholecystitis and choledocholithiasis. Upon undergoing laparoscopic cholecystectomy, she was found to have extensive fibrosis of the gallbladder, adhesions, and an impacted gallstone in the wall of the gallbladder. Imaging and endoscopic retrograde cholangiopancreatography performed prior to surgery did not detect a cholecystoduodenal fistula that was discovered intraoperatively. She was treated successfully with laparoscopic cholecystectomy and repair of the duodenum.
PubMed: 34987929
DOI: 10.7759/cureus.20049 -
Journal of Radiology Case Reports Oct 2020Bronchobiliary fistula (BBF) is a rare condition that results from the communication between the bile ducts and the bronchial tree. It is characterized by the presence...
Bronchobiliary fistula (BBF) is a rare condition that results from the communication between the bile ducts and the bronchial tree. It is characterized by the presence of bile in the sputum as pathognomonic symptom, and it is often associated with suspicious pneumonia. The most common causes include infections (e.g. echinococcosis), hepatobiliary surgery, blunt torso traumas, tumors and percutaneous transhepatic procedures. Opinions about BBF treatment are still controversial as it can be treated by both conservative and surgical procedures, while pharmacological treatments are only rarely used. This case report presents a patient who had been diagnosed with chronic BBF of unknown cause, underwent several ineffective conservative procedures and was at last surgically treated.
Topics: Aged; Biliary Fistula; Bronchial Fistula; Humans; Male; Tomography, X-Ray Computed
PubMed: 33708338
DOI: 10.3941/jrcr.v14i10.3743 -
Cirugia Pediatrica : Organo Oficial de... Jul 2021Congenital bronchobiliary fistula is an extremely rare malformation with high morbidity and mortality rates. Up to 2016, 36 cases had been reported worldwide.
INTRODUCTION
Congenital bronchobiliary fistula is an extremely rare malformation with high morbidity and mortality rates. Up to 2016, 36 cases had been reported worldwide.
CLINICAL CASE
11-year-old male patient with history of chronic lung disease and respiratory insufficiency, bile ptyalism and 66-80% arterial saturation, jaundice, asymmetric thorax, finger clubbing, and disseminated crackling rales. He was diagnosed through fibrobronchoscopy and CT-scan. After fistula closure and right pneumonectomy, recurrence occurred due to bile duct hypoplasia as evidenced by endoscopic retrograde cholangiopancreatography. Left lateral hepatic segmentectomy and fistula closure from the abdomen were carried out. Bronchopleural fistula persisted following intensive nutritional and antibiotic treatment. It was surgically closed using a bovine pericardial patch. Six months later, the patient had no symptoms.
DISCUSSION
Given how extremely rare this malformation is, cross-disciplinary treatment and a high grade of suspicion are needed. The presence of bile duct hypoplasia is to be considered, since it requires a thoracoabdominal approach.
Topics: Animals; Biliary Fistula; Bronchial Fistula; Cattle; Child; Cholangiopancreatography, Endoscopic Retrograde; Drainage; Humans; Liver; Male
PubMed: 34254750
DOI: No ID Found -
Annals of the Royal College of Surgeons... Sep 2018Gallstone ileus is an uncommon cause of bowel obstruction that involves cholecystoenteric fistulation and resultant passage of gallstones into the bowel. In the vast...
Gallstone ileus is an uncommon cause of bowel obstruction that involves cholecystoenteric fistulation and resultant passage of gallstones into the bowel. In the vast majority of cases, the fistula forms between the gallbladder and duodenum leading to small bowel obstruction. We report a case of cholecystocolic fistulation and subsequent large-bowel obstruction in a 75-year-old woman who presented acutely after taking a bowel preparation for an outpatient colonoscopy during the course of an investigation of anaemia and nonspecific abdominal pain. Preintervention imaging revealed a giant gallstone at the rectosigmoid junction, in the presence of a cholecystocolic fistula, and subsequent large bowel obstruction. After a failed period of expectant management, laparotomy and Hartmann's procedure were performed and the patient made an uneventful recovery.
Topics: Aged; Biliary Fistula; Colon; Female; Gallstones; Humans; Intestinal Fistula; Intestinal Obstruction; Laparotomy; Tomography, X-Ray Computed
PubMed: 30112951
DOI: 10.1308/rcsann.2018.0116 -
Internal Medicine (Tokyo, Japan) 2013
Topics: Aged; Aged, 80 and over; Biliary Fistula; Humans; Male; Mirizzi Syndrome; Stents; Tomography, X-Ray Computed
PubMed: 23774560
DOI: 10.2169/internalmedicine.52.0354 -
Arquivos Brasileiros de Cirurgia... 2022Biliary fistulas typically occur as surgical complications after laparoscopic cholecystectomy, liver transplantation, or partial liver resection.
BACKGROUND
Biliary fistulas typically occur as surgical complications after laparoscopic cholecystectomy, liver transplantation, or partial liver resection.
AIMS
This study aimed to evaluate the efficacy of the endoscopic treatment of biliary fistulae secondary to liver transplantation compared to that of other etiologies.
METHODS
A retrospective study of 25 patients undergoing endoscopic retrograde cholangiopancreatography for biliary fistula from 2015 to 2021 was conducted at the Endoscospy Unit of Walter Cantídio University Hospital. Clinical characteristics and endoscopic success rates of the post-liver transplantation group were analyzed in comparison with those of other etiologies.
RESULTS
The main causes of biliary fistula were liver transplantation (44%) and cholecystectomy complications (44%). The post-liver transplantation group had a significantly higher proportion of male sex (liver transplantation=81.8%, others=28.6%) and older age (liver transplantation=54.1 years, others=42.0 years) and a higher incidence of biliary stenosis (liver transplantation=90.9%, others=14.3%) than those of the group with other etiologies (p<0.05). The two groups received similar treatment types, among which sphincterotomy associated with biliary stent placement was most commonly used. Endoscopic therapeutic success rates showed no significant difference between the post-liver transplantation group (63.6%) and the group with other etiologies (71.4%).
CONCLUSIONS
The endoscopic treatment of biliary fistulae secondary to liver transplantation presented a recovery rate similar to that of other etiologies despite the patients older age and the presence of biliary stenosis.
Topics: Biliary Fistula; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis; Constriction, Pathologic; Humans; Liver Transplantation; Male; Postoperative Complications; Retrospective Studies; Sphincterotomy, Endoscopic; Stents
PubMed: 36134817
DOI: 10.1590/0102-672020220002e1685 -
Annals of Surgery Jan 1925
PubMed: 17865176
DOI: 10.1097/00000658-192501010-00026 -
Canadian Medical Association Journal May 1953
Topics: Bile Ducts; Biliary Fistula; Common Bile Duct; Duodenum; Fistula; Peptic Ulcer
PubMed: 13042730
DOI: No ID Found -
HPB Surgery : a World Journal of... 1997To reevaluate the current features of spontaneous internal biliary fistulas, we reviewed 1,929 consecutive patients who had been treated for biliary tract diseases...
To reevaluate the current features of spontaneous internal biliary fistulas, we reviewed 1,929 consecutive patients who had been treated for biliary tract diseases during the recent 12-year period. Thirty-three patients had internal biliary fistulas and the incidence was 1.9%. Of 33 patients, 20 were women and 13 were men with the average age 63 years, and their mean duration of illness was 4 years. A total of 37 fistulas were found and the most common type was choledochoduodenal (62%), followed by cholecystoduodenal (19%), cholecystocholedochal (11%) and cholecystocolonic (8%) fistulas. Internal biliary fistulas of thirty-one patients were caused by biliary stones and those of two patients by malignant tumors. All of the 17 bile samples examined were bacteria positive and the majority of calculi were brown pigment stones. All of the choledochoduodenal fistulas were correctly diagnosed by endoscopic retrograde cholangiography. In 14 patients with cholecystoenteric or cholecystocholedochal fistulas, direct evidence of the internal fistula was obtained only in 7 patients (50%) preoperatively. Pneumobilia, a small atrophic gallbladder adherent to the neighboring organs and a history of spontaneous disappearance of jaundice in elderly patients may indicate the presence of a cholecystoentric fistula. Since the preoperative diagnostic rate for internal biliary fistula involving the gallbladder is still low, care is necessary before and at the time of surgery especially during laparoscopic cholecystectomy for elderly patients with cholelithiasis.
Topics: Adult; Aged; Aged, 80 and over; Bile; Biliary Fistula; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy, Laparoscopic; Cholelithiasis; Female; Humans; Male; Middle Aged; Treatment Outcome
PubMed: 9174858
DOI: 10.1155/1997/95363 -
Pulmonology 2018
Topics: Aged, 80 and over; Biliary Fistula; Bronchial Fistula; Fatal Outcome; Humans; Male
PubMed: 30292325
DOI: 10.1016/j.pulmoe.2018.08.001