Estrada GRA, Mojarro CMÁ, Padilla ARI

Language: Spanish
References: 15
Page: 35-40
PDF size: 2556.06 Kb.

ABSTRACT

Introduction: cholecystocolonic fistula is an uncommon complication of cholelithiasis. It is associated with high morbidity and mortality due to a difficult preoperative diagnosis. Symptoms can be vague and nonspecific, or even manifest as gallstone ileus. Case presentation: a 72-year-old male with cholelithiasis presented with abdominal pain and distal intestinal obstruction. Contrast-enhanced CT scan revealed a 3 cm gallstone impacted in the sigmoid colon with proximal dilation and the gallbladder in contact with the transverse colon. A diagnostic-therapeutic colonoscopy allowed for stone extraction, followed by diagnostic laparoscopy, which identified the cholecystocolonic fistula. Reconstituting subtotal cholecystectomy and fistulectomy with an endoscopic stapler and intracorporeal suturing were performed. Conclusion: the combined laparoendoscopic approach resolved the obstruction and the fistula in a single hospital episode. This report is the first in Mexico to document the successful management of a cholecystocolonic fistula with sigmoid gallstone ileus using this approach.

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