Hens Brecht, Reynaert Hendrik
Gastroenterology and Hepatology, Universitair Ziekenhuis Brussel, Brussels, BEL.
Cureus. 2024 Nov 6;16(11):e73129. doi: 10.7759/cureus.73129. eCollection 2024 Nov.
A cholecystocolonic fistula (CCF) is a rare cause of chronic diarrhoea. It most often occurs in elderly women as a result of chronic inflammation due to gallstone disease or, rarely, malignancy. Curative treatment consists of cholecystectomy with excision of the fistula tract, but it is often overlooked preoperatively and thus entails a higher risk of postoperative complications. Here, we present a case of a 78-year-old woman with chronic diarrhoea who was diagnosed with a CCF during a colonoscopy. Cholecystectomy was complicated by acute cholangitis due to an obstructive stone in the common bile duct (CBD) that was masked preoperatively due to alternative biliary drainage via the CCF. Recognition of this rare entity can enhance clinicians' diagnostic appraisal and limit postoperative complications.
胆囊结肠瘘(CCF)是慢性腹泻的罕见病因。它最常发生于老年女性,是由胆结石疾病引起的慢性炎症所致,或极少情况下由恶性肿瘤引起。根治性治疗包括胆囊切除术及瘘管切除,但术前常被忽视,因此术后并发症风险较高。在此,我们报告一例78岁慢性腹泻女性病例,该患者在结肠镜检查时被诊断为CCF。胆囊切除术因胆总管(CBD)梗阻性结石并发急性胆管炎,该结石术前因通过CCF的替代性胆汁引流而被掩盖。认识到这种罕见疾病可提高临床医生的诊断评估能力并减少术后并发症。