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胆囊肠道联合瘘合并胆总管结石:1例罕见病例报告

Combined Cholecystoenteric Fistula and Choledocholithiasis: A Report of a Rare Case.

作者信息

Kovacheva-Slavova Mila, Dimitrov Victor, Gecov Plamen, Golemanov Branimir, Vladimirov Borislav

机构信息

Gastroenterology, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR.

Medical Imaging, University Hospital Tsaritsa Ioanna, Medical University of Sofia, Sofia, BGR.

出版信息

Cureus. 2024 Dec 30;16(12):e76608. doi: 10.7759/cureus.76608. eCollection 2024 Dec.

Abstract

Cholecystoenteric fistulas are a rare complication of chronic gallstone disease. If not diagnosed on time, they can cause several complications such as gallstone ileus, gastric outlet obstruction (Bouveret syndrome), cholangitis, or liver abscess. We present a case of a patient with chronic calculous cholecystitis, who was admitted due to unspecific abdominal discomfort and impaired liver function with increased cholestatic liver enzymes. We found a stone in the distal part of the common bile duct with the papilla orifice located in a duodenal diverticulum and a cholecystoduodenal fistula as an additional finding, which at that point was uncomplicated. After successful endoscopic therapy of the choledocholithiasis, the patient was referred for laparoscopic cholecystectomy and treatment of the fistula. During follow-up, the patient was in an excellent overall condition.

摘要

胆囊肠瘘是慢性胆结石疾病的一种罕见并发症。如果未能及时诊断,它们可能会引发多种并发症,如胆石性肠梗阻、胃出口梗阻(布韦里综合征)、胆管炎或肝脓肿。我们报告一例慢性结石性胆囊炎患者,该患者因非特异性腹部不适和肝功能受损、胆汁淤积性肝酶升高而入院。我们在胆总管远端发现一枚结石,乳头开口位于十二指肠憩室内,另外还发现一个胆囊十二指肠瘘,当时该瘘并无并发症。在成功进行内镜治疗胆总管结石后,患者被转诊接受腹腔镜胆囊切除术及瘘管治疗。在随访期间,患者总体状况良好。

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