Cavallaro Andrea, Lauretta Andrea, Lizzio Achille, Cavallaro Marco, Cavallaro Vincenzo
UO Chirurgia dell'Apparato Digerente, Azienda Policlinico Catania, Università degli studi di Catania.
Ann Ital Chir. 2005 Nov-Dec;76(6):573-6.
There are several varieties of bilioenteric fistulae. The vast majority of fistulas result from chronic cholelitiasis disease. Other relatevely common causes are chronic duodenal ulcer disease, previous instrumentation to the biliary system, chronic bowel inflammatory disease, traumatism, infections.
The case of a 58-year-old patient is reported in whom one of the rare complications of longstanding duodenal ulcer, the cholecystoduodenal fistula, has occurred. Main symptoms were rapid weight loss (20 kg/3 months), abdominal pain, dyspepsia, vomiting. Perivisceral peritonitis developed a tumefaction (diam: 5 cm) involving duodenum, pancreas, biliary tract and gallbladder. That finding closely simulated a neoplasm evaluating it by CT scan, US scan and even in explorative laparotomy: tumefaction was impossible to isolate, so a duodenocefalopancreasectomy was performed.
胆肠瘘有多种类型。绝大多数瘘是由慢性胆石症引起的。其他相对常见的病因包括慢性十二指肠溃疡病、既往胆道系统器械操作、慢性肠道炎症性疾病、创伤、感染。
报告了一名58岁患者的病例,该患者发生了长期十二指肠溃疡的罕见并发症之一,即胆囊十二指肠瘘。主要症状为体重迅速减轻(3个月内减轻20千克)、腹痛、消化不良、呕吐。内脏周围腹膜炎发展为一个肿物(直径:5厘米),累及十二指肠、胰腺、胆道和胆囊。通过CT扫描、超声扫描甚至在探查性剖腹手术中评估,该发现酷似肿瘤:肿物无法分离,因此进行了十二指肠胰头切除术。