Sunakawa Taiki, Ko Kenju, Moriyasu Ryo, Nishida Yasunori, Otagiri Noriaki, Tauchi Katsunori
Department of Surgery, Aizawa Hospital, Matsumoto, Japan.
J Surg Case Rep. 2020 Sep 15;2020(9):rjaa305. doi: 10.1093/jscr/rjaa305. eCollection 2020 Sep.
Preoperative diagnosis of cholecystocolonic fistula (CCF) is difficult and the contribution of gallbladder cancer or colon cancer is unclear when there is associated malignancy. We present a case that was diagnosed with acute cholecystitis associated with CCF by multidetector computed tomography (MDCT) preoperatively and malignant neoplasm during emergency surgery. She was finally diagnosed with gallbladder cancer after the operation and underwent a two-stage surgery for regional lymph node dissection. Gallbladder cancer can be a primary malignant cancer causing CCF, whereas MDCT is useful for preoperative diagnosis of CCF. A treatment plan in consideration of gallbladder cancer is advisable for CCF associated with malignant tumor.
胆囊结肠瘘(CCF)的术前诊断较为困难,当合并恶性肿瘤时,胆囊癌或结肠癌的作用尚不清楚。我们报告一例患者,术前通过多排螺旋计算机断层扫描(MDCT)诊断为与CCF相关的急性胆囊炎,急诊手术时发现为恶性肿瘤。术后最终诊断为胆囊癌,并接受了两阶段区域淋巴结清扫手术。胆囊癌可能是导致CCF的原发性恶性肿瘤,而MDCT对CCF的术前诊断很有用。对于合并恶性肿瘤的CCF,建议制定考虑胆囊癌的治疗方案。