1/330. Spontaneous cholecystocutaneous fistula presenting in the gluteal region.The complication of cholecystocutaneous fistula secondary to calculus cholelithiasis is an extremely rare occurrence. The incidence has further decreased with the advent of broad-spectrum antibiotics, ultrasonography, and safe and early surgical treatment of biliary tract disease. We are reporting a rare cholecystocutaneous fistula presenting in the right-side gluteal region below the iliac crest.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
2/330. Mucin-producing biliary papillomatosis associated with gastrobiliary fistula.We report a case of mucin-producing biliary papillomatosis in a 78-year-old woman. Abdominal ultrasound (US) and computed tomography (CT) showed wall thickening and dilatation of the intrahepatic bile duct (IHBD), as well as a nodular lesion, 1.2 cm in diameter, in the left branch of the IHBD. Gastric endoscopy revealed excretion of bile-containing mucin on the anterior wall of the body of the stomach. Endoscopic ultrasonography (EUS) showed gastrobiliary fistula and discharge of mucin into the stomach. Needle biopsy of the biliary tumor revealed papillary proliferation, but no malignant cells were recognized histologically. Therefore this patient was diagnosed as having mucin-producing biliary papillomatosis forming gastrobiliary fistula. She did not present with obstructive jaundice, probably because of the fistula. She is alive, without obstructive jaundice, 16 months after the diagnosis without having had surgery. This is, to our knowledge, the first reported case of biliary papillomatosis forming gastrobiliary fistula and with the patient free of obstructive jaundice.- - - - - - - - - - ranking = 522.57873283289keywords = biliary fistula, fistula (Clic here for more details about this article) |
3/330. Choledochoduodenal fistula at the anterior wall of the duodenal bulb: a rare complication of duodenal ulcer.A 38 year-old man was admitted to our hospital with the chief complaint of epigastralgia. His laboratory data revealed leukocytosis and increased serum amylase, and abdominal ultrasonography revealed diffuse swelling of the pancreas. Thus, he was diagnosed as having acute pancreatitis. Moreover, abdominal computed tomography showed pneumobilia in the gallbladder and the common bile duct. Gastroduodenal fiberscopy demonstrated peptic ulcer scars around a foramen with smooth margins at the anterior wall of the duodenal bulb. The bile juice flowed from the bottom of the foramen. Endoscopic retrograde cholangiopancreatography revealed the fistula between the common bile duct and the anterior wall of the duodenal bulb, but not the posterior wall. However, there was no pancreatico-biliary maljunction and no stones in the gallbladder or bile duct. This is a rare case of choledochoduodenal fistula at the anterior wall of the duodenal bulb caused by duodenal peptic ulcer disease.- - - - - - - - - - ranking = 1keywords = fistula (Clic here for more details about this article) |
4/330. Biliary-enteric fistulas: report of five cases and review of the literature.Internal biliary fistulas (IBF) are seen rarely. Because the symptoms and signs of IBF are not specific and the diagnosis is not suspected, these patients are commonly investigated with plain abdominal films (PAF), ultrasonography (US), upper gastrointestinal series (UGIS), barium enema (BE), and computed tomography (CT), but not always with endoscopic retrograde cholangiopancreatography (ERCP). The purposes of this article are (a) to attract attention of radiologists to presumptive findings of IBF, so as not to misdiagnose this unsuspected and rare disease, and (b) review of the literature while presenting radiologic features of our cases. Five cases of IBFs in which extrahepatic biliary tree communicating with duodenum (four cases) and colon (one case) are reported. Diagnostic work-up of cases were done by PAF, US, UGIS, BE, and CT. Aerobilia, which cannot be explained using other means, ectopic gallstone and small bowel dilatation, nonvisualization of the gallbladder despite no history of cholecystectomy, and thick-walled shrunken gallbladder adherent to neighboring organs were suggestive findings of IBF in our study. knowledge of imaging findings suggestive of IBF and a high index of suspicion increase the diagnostic rate of IBFs.- - - - - - - - - - ranking = 75.29696183327keywords = biliary fistula, fistula (Clic here for more details about this article) |
5/330. Interventional radiology in percutaneous management of bile duct obstruction: biliary drainage through a spontaneous common hepatic duct-duodenal fistula.Bile duct injuries are a serious complication of biliary surgery. We report a case of benign obstruction of the common hepatic duct associated with common hepatic duct-duodenal spontaneous fistula following complex surgical intervention. We managed percutaneously the fistula with balloon dilatation and long-term stenting, as the fistula allowed biliary flow in the duodenum. We avoided reintervention preserving biliary flow, with good clinical results after a follow-up of a 3 years. We emphasize the role of a clinically focused approach to percutaneous management of complications following biliary surgery.- - - - - - - - - - ranking = 1.1666666666667keywords = fistula (Clic here for more details about this article) |
6/330. Advanced adenosquamous carcinoma of the gallbladder with bilio-biliary fistula: an uncommon case treated by hepatopancreatoduodenectomy.A 70 year-old female, who presented with jaundice and abdominal pain, was found to have an advanced gallbladder cancer involving the liver parenchyma, duodenum, and transverse colon. This was complicated by a bilio-biliary fistula between the gallbladder and both the right and left hepatic ducts. After obtaining an accurate pre-operative diagnosis, the patient underwent hepatopancreatoduodenectomy (HPD) with lymph node dissection around the hepatic pedicle, celiac trunk, aorta, and inferior vena cava. Histologic examination revealed adenosquamous carcinoma. This rare variant accounts for 3.5% of gallbladder cancers, and is associated with a worse prognosis than adenocarcinoma. The patient is in good condition without any signs of recurrence 42 months after the HPD. In this case report, we discuss the histological type and internal biliary fistula with regard to the literature, and the usefulness of an aggressive surgical procedure such as HPD with extended lymph node dissection which can improve survival and quality of life in selected patients.- - - - - - - - - - ranking = 447.78177099962keywords = biliary fistula, fistula (Clic here for more details about this article) |
7/330. gallbladder carcinoma with choledochoduodenal fistula: a case report with surgical treatment.A 79 year-old man was admitted to our hospital because of upper abdominal pain and nausea. A mobile tumor was palpable in the right upper abdomen. Abdominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed a fistula 1.5 cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreatoduodenectomy associated with reconstruction using Imanaga's method was performed under a pre-operative diagnosis of gallbladder carcinoma with choledochoduodenal fistula. The gallbladder contained a tumor and two bilirubin stones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistula stimulated the development of cancer due to chronic irritation from pancreatic juice reflux.- - - - - - - - - - ranking = 1.1666666666667keywords = fistula (Clic here for more details about this article) |
8/330. Preservative treatment for biliobiliary fistula.Biliobiliary fistula is thought to be a rare type of internal biliary fistula. A 68-year-old man presented to our hospital with complaints of jaundice and general malaise. Endoscopic retrograde cholangiography was performed, but the gallbladder was not imaged. Mirizzi's sign was observed in the common hepatic duct. During the course of evaluating this inpatient, imaging revealed that a gallstone was extruded to the right hepatic duct. After incision of the papilla, stones in the bile duct were subjected to mechanical lithotripsy and were extracted. As a result of bile duct decompression, the biliobiliary fistula was closed completely 2 months later.- - - - - - - - - - ranking = 522.41206616622keywords = biliary fistula, fistula (Clic here for more details about this article) |
9/330. Chronic cough due to bronchobiliary fistula.Bronchobiliary fistula is a rare cause of chronic cough. Here we describe a 70-year-old woman complaining of chronic cough and copious dark-yellow watery sputum. The presence of air in the biliary tract in the lower cuts of a computerized tomography scan of the chest and positive bile in the sputum led to the suspicion of bronchobiliary fistula. The diagnosis was confirmed by percutaneous transhepatic cholangiography. drainage of the intrahepatic biliary tract resulted in complete resolution of her symptoms.- - - - - - - - - - ranking = 447.78177099962keywords = biliary fistula, fistula (Clic here for more details about this article) |
10/330. A case of bilioduodenal fistula treated with a self-expandable metallic stent.We report the case of a 72 year-old female patient who suffered from biliary fistulae. The biliobiliary and bilioduodenal fistulae appeared after an operation for biliary bleeding. Conventional therapy for biliary fistula would be the disconnection of the fistula by either conservative or operative treatment. In the present case, however, it was preferable to enlarge the fistula to drain bile juice into the duodenum, rather than to close the fistula because it would have been difficult to achieve a tight adhesion with this operation. The enlargement by a plastic tube stent failed to drain the bile juice into the duodenum, because the sludge made the tube stenotic. Therefore, a self-expandable metallic stent was applied in this case. An expandable stent was used because a large final caliber is necessary to prevent stenosis of the fistula by sludge and mucosal hyperplasia. After insertion of a self-expandable metallic stent by the percutaneous transhepatic biliary drainage route, the patient has not suffered from cholestasis and cholangitis for the last 30 months. It can therefore be concluded that enlargement of the fistula by a self-expandable metallic stent is a convenient therapy for such biliointestinal fistulae.- - - - - - - - - - ranking = 151.09392366654keywords = biliary fistula, fistula (Clic here for more details about this article) |
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