Guardado-Bermúdez Fernando, Aguilar-Jaimes Araceli, Ardisson-Zamora Fernando Josafat, Guerrero-Silva Luis Alberto, Villanueva-Rodríguez Estefanie, Gómez-de Leija Nubia Alondra
Servicio de Cirugía General, Departamento de Cirugía, Hospital Civil de Ciudad Madero, Ciudad Madero, Tamaulipas, México.
Servicio de Cirugía General, Departamento de Cirugía, Hospital Civil de Ciudad Madero, Ciudad Madero, Tamaulipas, México.
Cir Cir. 2015 Jan-Feb;83(1):61-4. doi: 10.1016/j.circir.2015.04.026.
Spontaneous cholecystocutaneous fistula is defined as a gallbladder communication with the external environment through the abdominal wall rupture; the first reports were written in the seventeenth century by Thilesus. During the past 50 years 25 cases have been reported.
We report a case of a 30-year-old woman presented with a five-year history of biliary colic, six months prior to medical assessment presents outlet of biliary material and gallstones spontaneously in the right upper quadrant. Fistulogram was performed without evidence of obstruction, subsequently cholecystectomy and resection of the fistula was performed.
The biliary fistulas are an abnormal communication from the gallbladder into another surface, is a rare condition in our day as it only occurs in 10% of patients with gallbladder lithiasis; while spontaneous cholecystocutaneous fistula clinic is more than evident. It is imperative perform studies like ultrasound, tomography, and fistulogram. The mainstay of treatment is cholecystectomy, resection of the fistula and repair of abdominal wall defect.
The incidence of cholecystocutaneous fistula today is minimal and it seems that the current trend is to become an entity anecdotal, the approach subcostal abdominal examination remains as the first choice. The laparoscopic approach is an option reserved for the experienced surgeon.
自发性胆囊皮肤瘘被定义为胆囊通过腹壁破裂与外界环境相通;最早的报告由蒂勒苏斯在17世纪撰写。在过去50年里共报告了25例病例。
我们报告一例30岁女性病例,该患者有5年胆绞痛病史,在接受医学评估前6个月,右上腹自发出现胆汁和胆结石排出。进行了瘘管造影,未发现梗阻迹象,随后进行了胆囊切除术和瘘管切除术。
胆瘘是胆囊与另一个表面之间的异常相通,在当今是一种罕见病症,仅发生于10%的胆囊结石患者中;而自发性胆囊皮肤瘘的临床症状则较为明显。必须进行超声、断层扫描和瘘管造影等检查。治疗的主要方法是胆囊切除术、瘘管切除术和腹壁缺损修复术。
如今胆囊皮肤瘘的发病率极低,似乎当前的趋势是它会成为一种罕见病症,肋下腹部检查仍是首选方法。腹腔镜手术方法是留给经验丰富外科医生的一种选择。