Gallbladder-duodenal fistula presenting with liver abscess and upper gastrointestinal bleeding.
BACKGROUND
Bilio-enteric communications leading to liver abscess formation are encountered rarely and are therefore not easily suspected by the attending physician.


METHODS
A bilio-enteric communication involving the gallbladder and the duodenum presented as a septic event with upper gastrointestinal bleeding in a 71-year-old man who was wrongly thought to have undergone a previous cholecystectomy. A pyogenic bacterial liver abscess developed from the fistula in the absence of biliary obstruction. The patient was treated surgically with disconnection of the fistula and drainage of the abscess.


CONCLUSIONS
The liver abscess presumably arose as a consequence of contamination of the bile via the cholecysto-duodenal fistula. The previous operation is likely to have been a simple cholecystostomy.
Stamou
K M
KM
1st Department of Propaedeutic Surgery, Hippokrateion Hospital, Athens, Greece. cstamou@hotmail.com
Kekis
P B
PB
Glynatsis
M
M