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KMID : 0378019690120010103
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New Medical Journal
1969 Volume.12 No. 1 p.103 ~ p.105
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Spontaneous Cholecysto-duodenal Fistula
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李永胄/Lee, Y. J
韓景濬/Hahn, K. C
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Abstract
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Spontaneous internal biliary fistula is a very rare condition. It may be divided into following types. 1. Duodenal-biliary fistula. 2. Biliary-colonic fistula. 3. Biliary-gastric fistula. 4. Fistula between the bile ducts. 5. Bronchobiliary fistula. 6. Other rare internal biliary fistula. Among the above, the 1 common type is cholecysto-duodenal fistula which usually resulted from chronic inflammatory adhesion of the gall bladder to the duodenum.
Gallstone is considered-7as an etiological factor since it is not uncommonly found in the case of cholecysto-duodenal fistula.
Frequently it attacks older age group over 60 and reported as female preponderance.
A case of spontaneous cholecysto-duodenal fistula was treated in the Dept. of Surgery, St. Paul´s Hospital,. Catholic Medical College. It was 69years-old male, complained of nausea, vomitting, fever, jaundice and pain in the right upper abdomen.
Under the clinical diagnosis of cholecystopathy, laparatomy was done. Operative finding showed inflammatory adhesion between gallbladder, duodenum and common bile duct. On opening of the gallbladder, no stone was identified, however, the wall is thickened.
A fistulous tract was found in the base of the gallbladder, communicating with upper portion of the duodenum.
Cholecystectomy, fistulectomy and adhesiotomy were carried out, and the patient was recovered uneventfully.
In this case the previous existance of the stone shoule not be proved but a consideration bepaid that the store has passed through the fistula into the alimentary canal.
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