Lee Charles K, Ramcharan Darren N, Alaimo Kayla L, Velez Veronica, Risden Anika E, Klein Dhadon H, Garcia Osbaldo, Joshi Vaidehi, Jorge Juaquito M
Medicine, Saint James School of Medicine, Park Ridge, USA.
Surgery, West Suburban Medical Center, Oak Park, USA.
Cureus. 2021 Nov 30;13(11):e20049. doi: 10.7759/cureus.20049. eCollection 2021 Nov.
Cholecystoduodenal fistulas are a type of internal biliary fistula that occur due to chronic inflammation of the gallbladder/biliary tree; if left untreated, perforation and necrosis can occur. Cholecystoduodenal fistulas are often difficult to diagnose due to their non-specific signs and symptoms. Since the widespread use of techniques such as magnetic resonance cholangiopancreatography and imaging modalities such as computed tomography, the frequency of reports describing intraoperative cholecystoduodenal fistula has reduced dramatically. Here, we report the case of a 54-year-old female who presented with a two-day history of non-radiating epigastric abdominal pain, initially diagnosed with acute cholecystitis and choledocholithiasis. Upon undergoing laparoscopic cholecystectomy, she was found to have extensive fibrosis of the gallbladder, adhesions, and an impacted gallstone in the wall of the gallbladder. Imaging and endoscopic retrograde cholangiopancreatography performed prior to surgery did not detect a cholecystoduodenal fistula that was discovered intraoperatively. She was treated successfully with laparoscopic cholecystectomy and repair of the duodenum.
胆囊十二指肠瘘是一种肝内胆管瘘，由于胆囊/胆管树的慢性炎症而发生；如果不治疗，可能会发生穿孔和坏死。胆囊十二指肠瘘由于其非特异性的体征和症状，往往难以诊断。自从磁共振胰胆管造影等技术和计算机断层扫描等成像方式广泛应用以来，描述术中胆囊十二指肠瘘的报告频率已大幅降低。在此，我们报告一例54岁女性病例，该患者有两天的上腹部非放射性腹痛病史，最初被诊断为急性胆囊炎和胆总管结石。在接受腹腔镜胆囊切除术时，发现她的胆囊有广泛纤维化、粘连，胆囊壁有嵌顿结石。术前进行的影像学检查和内镜逆行胰胆管造影未检测到术中发现的胆囊十二指肠瘘。她通过腹腔镜胆囊切除术和十二指肠修复术获得成功治疗。
