Bhamrah Jasprit, Diep Phuoc-Tan, Bennet John, Warren Hugh
Queen Elizabeth Hospital, Norfolk, UK.
J Surg Case Rep. 2010 Nov 1;2010(9):6. doi: 10.1093/jscr/2010.9.6.
Cholecystitis can result in complications if not completely treated. These include gallbladder empyema, perforation and cholecystoenteric fistula. We report the first incidence of cholecystitis resulting in a gallstone fistula with a gastric duplication cyst. A 71 year old patient presented with generalised peritonism that was worst in the epigastric area. Computer tomography (CT) revealed a perforated necrotic gallbladder. Emergency laparotomy, cholecystectomy, partial gastrectomy and Roux-en-Y reconstruction was required. The patient made a slow but full recovery. Pathology results revealed that chronic cholecystitis had resulted in a fistula with a duplication cyst overlying the greater curve of the stomach. Several one centimeter gallstones were found within the cyst cavity.
胆囊炎若未得到彻底治疗可能会引发并发症。这些并发症包括胆囊积脓、穿孔以及胆囊肠瘘。我们报告了首例胆囊炎导致胆结石瘘合并胃重复囊肿的病例。一名71岁患者出现全腹压痛，以上腹部最为严重。计算机断层扫描（CT）显示胆囊穿孔坏死。需要进行急诊剖腹手术、胆囊切除术、部分胃切除术以及Roux-en-Y重建术。患者恢复缓慢但完全康复。病理结果显示，慢性胆囊炎导致了瘘管形成，瘘管与覆盖胃大弯的重复囊肿相通。在囊肿腔内发现了几块一厘米大小的胆结石。
