Cholecystoduodenal Fistula with Impending Gallstone Ileus

AbstractLarge gallstones could erode through gallbladder wall to nearby structures, causing fistulas, gastric outlet obstruction and gallstone ileus. They typically occur in elderly patients with comorbidities carrying therapeutic challenges. We present a case of a middle-aged woman who was thought to have symptomatic cholelithiasis. Extensive adhesions precluded safe cholecystectomy. While hepatobiliary iminodiacetic acid scan and magnetic resonance imaging with cholangiopancreatography (MRI-MRCP) failed to visualize the gallbladder, computed tomography (CT) was consistent with cholecystoduodenal fistula. A very large gallstone was seen endoscopically in the duodenum, which was broken down into pieces using a large stiff snare.

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Gallstone Ileus due to cholecystoduodenal fistula

Erciyes Medical Journal ◽

10.14744/etd.2019.54926 ◽

2019 ◽

Author(s):

Daniel Kostov

Keyword(s):

Gallstone Ileus ◽

Cholecystoduodenal Fistula

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Tríada de Rigler radiológica en un caso de íleo biliar

Revista Argentina de Cirugía ◽

10.25132/raac.v112.n2.1469.es ◽

2020 ◽

Vol 112 (2) ◽

pp. 203-204

Author(s):

Martín Varela Vega ◽

◽

Micaela Mandacen ◽

Andrés Pouy

Keyword(s):

Gastrointestinal Tract ◽

Small Bowel ◽

Rare Complication ◽

Gallstone Ileus ◽

Mechanical Obstruction ◽

Cholecystoduodenal Fistula ◽

Radiographic Evidence ◽

Rigler’S Triad

Background: gallstone ileus is a rare complication of cholelithiasis. It is defined as a mechanical obstruction of the small bowel due to impaction of large gallstones into the gastrointestinal tract, generally though a cholecystoduodenal fistula. Rigler’s triad (pneumobilia, ectopic gallstone and mechanical obstruction) occurs in 30% of the patients. Surgery is indicated and includes enterotomy with gallstone extraction. Objective: we report a case of gallstone ileus with radiographic evidence of Rigler’s triad

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A CASE OF GALLSTONE ILEUS PERFORMED ELECTIVE OPERATION FOR CHOLECYSTODUODENAL FISTULA AFTER RELEASING OBSTRUCTION SYMPTOM BY USE OF LONG INTESTINAL DECOMPRESSION TUBE

The journal of the Japanese Practical Surgeon Society ◽

10.3919/ringe1963.43.433 ◽

1982 ◽

Vol 43 (4) ◽

pp. 433-438

Author(s):

Ken-ichi KONO ◽

Hisashi OKA

Keyword(s):

Gallstone Ileus ◽

Cholecystoduodenal Fistula ◽

Elective Operation ◽

Intestinal Decompression ◽

Decompression Tube

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Like a “Rolling” Gallstone: Cholecystoduodenal Fistula as Evidence of Gallstone Ileus

Digestive Diseases and Sciences ◽

10.1007/s10620-020-06088-7 ◽

2020 ◽

Vol 65 (9) ◽

pp. 2518-2520

Author(s):

Hannah Ramrakhiani ◽

Nicole Simpson ◽

Seth D. Strichartz ◽

Katerina Shetler ◽

George Triadafilopoulos

Keyword(s):

Gallstone Ileus ◽

Cholecystoduodenal Fistula

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Bouveret’s Syndrome: A Case Report and a Brief Literature Review

Acta Médica Portuguesa ◽

10.20344/amp.11664 ◽

2020 ◽

Vol 33 (5) ◽

pp. 347

Author(s):

Rita Peixoto ◽

Joana Correia ◽

Mário Guimarães Soares ◽

António Gouveia

Keyword(s):

Case Report ◽

Diagnostic Tests ◽

Gallstone Ileus ◽

Outlet Obstruction ◽

Exploratory Laparotomy ◽

The Elderly ◽

Cholecystoduodenal Fistula ◽

Bouveret’S Syndrome ◽

Clinical Surveillance ◽

Bouveret's Syndrome

Bouveret’s syndrome is a rare cause of gastric outlet obstruction. We report a case of a 68-year-old woman admitted with upper digestive obstruction. A few months later, and after several diagnostic tests and clinical surveillance, a cholecystoduodenal fistula was suspected. During exploratory laparotomy, the diagnosis of Bouveret’s syndrome was confirmed and a pyelolithotomy, pyloroplasty and a cholecystectomy were performed. The patient was asymptomatic 7 months after the operation. This syndrome represents only 1% - 3% of all cases of gallstone ileus, being more frequent in women and in the elderly. The presentation is quite nonspecific, but in most cases the symptomatology suggests an upper digestive occlusion. Treatment can be achieved by lithotripsy, but most patients require a surgical approach.

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Bouveret Syndrome—The Rarest Variant of Gallstone Ileus: A Case Report and Literature Review

Case Reports in Surgery ◽

10.1155/2013/839370 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Vasileios K. Mavroeidis ◽

Dimitrios I. Matthioudakis ◽

Nikolaos K. Economou ◽

Ioannis D. Karanikas

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Gallstone Ileus ◽

Surgical Techniques ◽

Outlet Obstruction ◽

Cholecystoduodenal Fistula ◽

Endoscopic Techniques ◽

History Of ◽

Bouveret Syndrome ◽

The Right

We present a case report of a patient with Bouveret syndrome with interesting radiological findings and successful surgical treatment after failure of the endoscopic techniques. The report is followed by a review of the literature regarding the diagnostic means and proper treatment of this rare entity. Bouveret syndrome refers to the condition of gastric outlet obstruction caused by the impaction of a large gallstone into the duodenum after passage through a cholecystoduodenal fistula. Many endoscopic and surgical techniques have been described in the management of this syndrome. This is a case of a 78-year-old patient with severe medical history who presented in bad general condition with an 8-day history of nausea, multiple bilious vomiting episodes, anorexia, discomfort in the right hypochondrium and epigastrium, and fever up to 38,5°C. The diagnosis of Bouveret syndrome was set after performing the proper imaging studies. An initial endoscopic effort to resolve the obstruction was performed without success. Surgical treatment managed to extract the impacted gallstone through an enterotomy after removal into the first part of the jejunum.

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