Cholecystoenteric fistula in a patient with advanced gallbladder cancer: A case report and review of literature  

作　　者：Chun-Yu Wang Sung-Hua Chiu Wei-Chou Chang Meng-Hsing Ho Ping-Ying Chang 

机构地区：[1]Department of General Medicine,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan [2]Department of Radiology,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan [3]Division of General Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan [4]Division of Hematology/Oncology,Department of Internal Medicine,Tri-Service General Hospital,National Defense Medical Center,Taipei 114,Taiwan

出　　处：《World Journal of Clinical Cases》2023年第36期8519-8526,共8页世界临床病例杂志

摘　　要：BACKGROUND Cholecystoenteric fistula(CEF)involves the formation of a spontaneous ano-malous tract between the gallbladder and the adjacent gastrointestinal tract.Chronic gallbladder inflammation can lead to tissue necrosis,perforation,and fistulogenesis.The most prevalent cause of CEF is chronic cholelithiasis,which rarely results from malignancy.Because the symptoms and laboratory findings associated with CEF are nonspecific,the condition is often misdiagnosed,pre-senting a challenge to the surgeon when detected intraoperatively.Therefore,a preoperative diagnosis of CEF is crucial.We present the case of a 57-year-old male with advanced gallbladder cancer(GBC)who arrived at the emergency room with persistent vomiting,abdominal pain,and diarrhea.An abdominopelvic computed tomography scan revealed a contracted gallbladder with bubbles in the fundus connected to the second por-tion of the duodenum and transverse colon.We suspected that GBC had invaded the adjacent gastrointestinal tract through a cholecystoduodenal fistula(CDF)or a cholecystocolonic fistula(CCF).He underwent multiple examinations,including esophagogastroduodenoscopy,an upper gastrointestinal series,colo-noscopy,and magnetic resonance cholangiopancreatography;the results of these tests con-firmed a diagnosis of synchronous CDF and CCF.The patient underwent a Roux-en-Y gastrojejunostomy and loop ileostomy to address the severe adhesions that were previously observed to cover the second portion of the duodenum and hepatic flexure of the colon.His symptoms improved with supportive treatment while hospitalized.He initiated oral targeted therapy with lenvatinib for further anticancer treatment.CONCLUSION The combination of imaging and surgery can enhance preoperative diagnosis and alleviate symptoms in patients with GBC complicated by CEF.

关 键 词：Cholecystoenteric fistula Biliary enteric fistula Cholecystoduodenal fistula Cholecystocolonic fistula Gallbladder neoplasms Case report 

分 类 号：R73[医药卫生—肿瘤]