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Cholecystocolic fistula demonstrated by endoscopic retrograde cholangiopancreatography

Gastroenterology Department, 251 Hellenic Air Force and Veterans General Hospital, Athens, Greece

Correspondence to:
Correspondence to:
Dr George K Anagnostopoulos
34 Dimokritou str, 15343, Agia Paraskevi, Athens, Greece; gkanagnostopoulos@yahoo.gr

Keywords: cholecystocolic fistula; endoscopic retrograde cholangiopancreatography

The first 150 words of the full text of this article appear below.

Cholecystocolic fistulas comprise between 10% and 20% of all biliary intestinal fistulas. In the majority of cases they are a sequel of cholecystitis but are reported to complicate only 0.13% of cases.¹

A 72 year old man was admitted in our hospital for evaluation of unexplained pneumobilia demonstrated on a routine ultrasound examination of the abdomen. The patient admitted that in previous years he had recurrent episodes of biliary-type pain accompanied by low grade fever, but in the previous nine months he had been free of symptoms from the biliary tract. Barium enema was normal and blood examination showed no abnormalities. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a cholecystocolic fistula (fig 1). The patient underwent cholecystectomy, excision of the fistula, bile duct exploration, and intraoperative cholangiography.

View larger version (123K): [in this window] [in a new window]   Figure 1  Visualisation of the colon shortly after cannulation of the common bile duct and contrast medium injection during ERCP.