Shams Christienne, Cannon Michael, Bortman Jared, Hakim Seifeldin
Department of Internal of Medicine, Beaumont Health, Royal Oak, MI.
Department of Gastroenterology, Beaumont Health, Royal Oak, MI.
ACG Case Rep J. 2018 Aug 29;5:e60. doi: 10.14309/crj.2018.60. eCollection 2018.
A biliary enteric fistula (BEF) is a rare, abnormal communication between any segment of the biliary tree with any portion of the small or large intestine. BEF is more frequently diagnosed with the increasingly widespread use of endoscopic retrograde cholangiopancreatography. Different theories have been postulated regarding the etiology of this fistula formation, with the most likely cause being gallstones. Treatment modalities, ranging from conservative management to surgical reconstruction, show varying levels of success. We present a case of BEF secondary to large common bile duct stones, successfully treated with endoscopic sphincterotomy (EST) followed by papillary balloon dilatation, and we briefly discuss large stone retrieval in the setting of atypical anatomy.
胆肠瘘（BEF）是一种罕见的疾病，指胆道系统的任何节段与小肠或大肠的任何部分之间存在异常连通。随着内镜逆行胰胆管造影术的日益广泛应用，胆肠瘘的诊断也更加频繁。关于这种瘘管形成的病因有不同的理论假说，最可能的原因是胆结石。治疗方式从保守治疗到手术重建不等，成功率各异。我们报告一例继发于胆总管巨大结石的胆肠瘘病例，通过内镜括约肌切开术（EST）继以乳头球囊扩张术成功治疗，并且简要讨论在非典型解剖结构情况下的巨大结石取出术。
