Abstract

Case Report

Cholecysto-colonic fistula after xanthogranulomatous cholecystitis: Surgeon’s nightmare

Karan Agarwal and Badareesh Lakshminarayana*

Published: 09 February, 2021 | Volume 5 - Issue 1 | Pages: 004-006

Xanthogranulomatous cholecystitis is a rare benign inflammatory disease of gallbladder that may be misdiagnosed as carcinoma of the gallbladder intraoperative or in pre-operative imaging. Intramural accumulation of lipid-laden macrophages and acute and chronic inflammatory cells is the hallmark of the disease. The xanthogranulomatous inflammation can be very severe and can spill over to the neighboring structures like liver, bowel and stomach resulting in dense adhesions, abscess formation, perforation, and fistulous communication with adjacent bowel [1-3]. Cholecysto-colic fistula is a rare and late complication of gallstones roughly found 1 in every 1,000 cholecystectomies.

Clinical features
The clinical features are variable and non-specific. Patients with cholecysto-colonic fistula often present with symptoms of acute cholecystitis and preoperative diagnostic tools often fail to show the fistula. Hence most cases it is an on table diagnosis.

Management
Treatment involves closing the fistula and performing an open or laparoscopic cholecystectomy.

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Keywords:

Cholecysto-colonic fistula; Cholecystoenteric fistula; Xanthogranulomatous cholecystitis

References

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