Pneumobilia--clue to an unusual cause of diarrhea.
A 65-year lady presented with diarrhea and weight loss of six months duration. Initial evaluation suggested that malabsorption was the possible underlying mechanism for the diarrhea. Work up for the common etiologies of malabsorption was non-contributory. Presence of pneumobilia raised the suspicion of a bilio-enteric fistula, which was subsequently confirmed on barium enema and endoscopic cholangio-pancreaticography to be a cholecystocolic fistula. At surgery, a fistulous tract from the fundus of the gallbladder was found to be communicating with the hepatic flexure. Fistulectomy with cholecystectomy resulted in prompt relief of symptoms. Cholecystocolic fistula (CCF) is a rare biliary fistula with diverse presentation.
Dutta
U
U
Department of Gastroenterology and Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India-160 012. ushad@satyam.net.in
Nagi
B
B
Kumar
A
A
Vaiphei
K
K
Wig
J D
JD
Singh
K
K
D000368:Aged; D001466:Barium Sulfate; D001658:Biliary Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology*; D004733:Enema; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography
D001466:Barium Sulfate