cholecystoduodenal fistula

cho·le·cys·to·du·o·de·nal fis·tu·la

an abnormal communication between gallbladder and duodenum, often secondary to severe cholecystitis with perforation and abscess formation; when stones are present in the gallbladder they may erode through the adjacent duodenal wall; if large stones pass into the duodenum, they may cause gallstone ileus.
References in periodicals archive ?
The most common mechanism of gallstone ileus formation is migration of a gallstone through the cholecystoduodenal fistula to remain impacted in the distal ileum lumen and causing an intestinal obstruction (3,4).
The passage of a large gallstone through a cholecystoduodenal fistula and the subsequent impaction in the duodenum causing gastric outlet obstruction are a rare occurrence and this is known as Bouveret syndrome.
All the previous reported cases describe Bouveret syndrome mostly secondary to cholecystoduodenal fistula. Most of the bilioenteric fistulas are associated with cholelithiasis but choledochoduodenal fistulas are unique as they are predominantly attributed to duodenal peptic ulcers (75-80%) and are a rare occurrence [1-3].
There have been three reports of gallbladder pulse granulomas, one in association with a cholecystoduodenal fistula related to cholecystitis and cholelithiasis [11] and one with a cholecystogastric fistula with chronic cholecystitis [12].
Reasons for conversion to open surgery reported in literature include injury to bowel and major blood vessels, bleeding, avulsion of cystic duct, duodenal injury, cholecystoduodenal fistula, respiratory acidosis, dense adhesions at Calot's triangle, difficult and obscure anatomy, severe inflammation, injury to bile ducts, abnormal intraoperative cholangiogram, unsuspected pathology and equipment failure10.
A cholecystoduodenal fistula was left intact because the chances of recurrence are very low and the patient did not have residual gallstones.
A case of gallstone ileus displaying spontaneous closure of cholecystoduodenal fistula after enterolithotomy.
In about 50% there is a history of jaundice, either in the past or at presentation, and loose bowel motions may be associated with a cholecystocolonic fistula (7) Severe haemorrhage complicating cholecystoduodenal fistula has also been reported (7).
Upon relieving the obstruction, a cholecystoduodenal fistula was palpated and also visualized via the endoscope.
In one patient (2.5%) the procedure was converted to open cholecystectomy (OC) due to finding of cholecystoduodenal fistula on laparoscopy.
During the operation, the presence of a cholecystoduodenal fistula was confirmed, and signs of bile duct ischemia were found.
In 2.5% to 14% of cases conversion of LC to OC is needed8-10due to massive bleeding bile duct injuries obscure anatomy bowel injuries and cholecystoduodenal fistula although surgeons do not consider it a complication.