Kong C Y, Glen P
Department of General Surgery, Queen Elizabeth University Hospital , Glasgow , UK.
School of Medicine, Dentistry and Nursing, University of Glasgow , Glasgow , UK.
Ann R Coll Surg Engl. 2019 Feb;101(2):e59-e61. doi: 10.1308/rcsann.2018.0192. Epub 2018 Oct 24.
An 84-year-old woman presented with acute worsening of diarrhoea for a few weeks, with a background of chronic diarrhoea over the past 12 months accompanied by weight loss. Computed tomography during this admission revealed air in the biliary tree and resolution of gallstones in keeping with a cholecystocolonic fistula. Owing to her comorbidities, surgical management was deemed not to be the best option. She was trialled on octreotide, a somatostatin analogue, which effectively resolved her symptoms. This case presents an effective and novel method of managing cholecystocolonic fistulas conservatively in a patient where medical therapy is the ceiling of care.
一名84岁女性,数周来腹泻急性加重,过去12个月有慢性腹泻病史并伴有体重减轻。此次入院时的计算机断层扫描显示胆道内有气体,胆结石消失,符合胆囊结肠瘘的表现。鉴于其合并症,手术治疗被认为并非最佳选择。她接受了奥曲肽(一种生长抑素类似物)试验性治疗,症状得到有效缓解。该病例展示了一种在以药物治疗为最高治疗手段的患者中保守治疗胆囊结肠瘘的有效且新颖的方法。