[Cholecistocolic fistula: an uncommon cause of lower gastrointestinal bleeding]. 2012

M Ostiz, and J J Vila, and J L García Sanchotena, and S Ostiz, and I Alaez
Servicio de Aparato Digestivo, Hospital Reina Sofía, 31500, Tudela, Spain. miriam.ostiz@gmail.com

Cholecystocolic fistula is an uncommon biliary-enteric fistula with a variable clinical presentation that usually appears as a rare complication of gallstone disease. It can present with abdominal pain, nausea, weight loss, diarrhoea with or without associated steatorrhea, and dyspeptic symptoms. Rare cases have been reported with lower gastrointestinal haemorrhage and even with a gallstone ileous. The most useful techniques for diagnosis are CT, barium studies, and ERCP. We report a case of a cholecistocolic fistula in an elderly woman with multiple medical comorbidities that presented as lower gastrointestinal bleeding. She was explored with colonoscopy, abdominal CT and barium enema. She required a total of 4 units of whole blood and because of her comorbidities a decision was made not to proceed with invasive treatment. She had a good evolution and was asymptomatic two months later.

UI MeSH Term Description Entries
D007412 Intestinal Fistula An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS). Cholecystoduodenal Fistula,Colovesical Fistula,Enterocutaneous Fistula,Fistula, Cholecystoduodenal,Fistula, Colovesical,Fistula, Enterocutaneous,Fistula, Intestinal
D003108 Colonic Diseases Pathological processes in the COLON region of the large intestine (INTESTINE, LARGE). Colonic Disease,Disease, Colonic,Diseases, Colonic
D005260 Female Females
D005705 Gallbladder Diseases Diseases of the GALLBLADDER. They generally involve the impairment of BILE flow, GALLSTONES in the BILIARY TRACT, infections, neoplasms, or other diseases. Gall Bladder Diseases,Bladder Disease, Gall,Bladder Diseases, Gall,Disease, Gall Bladder,Disease, Gallbladder,Diseases, Gall Bladder,Diseases, Gallbladder,Gall Bladder Disease,Gallbladder Disease
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001658 Biliary Fistula Abnormal passage in any organ of the biliary tract or between biliary organs and other organs. Biliary Fistulas,Fistula, Biliary,Fistulas, Biliary

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