title: Gallbladder papillomatosis and cholecystocolonic fistula: a rare combination.
abstract: BACKGROUND
  Biliary papillomatosis (BP) with sole involvement of the gall bladder or gall bladder papillomatosis (GBP) is very rare. Biliary-enteric fistula, particularly the cholecystocolonic fistula (CCF) type, is also very rare. The combination of both types of lesions in a single patient has never previously been reported in the English literature.
  
  
  METHODS
  We report herein the case of an 81-year-old woman who was diagnosed with both disease entities, which occurred in a cause-and-effect relationship. She underwent resection of the gall bladder with closure of the fistula, and was discharged improved afterwards.
  
  
  CONCLUSIONS
  GBP is a premalignant condition that warrants extensive resection. An absent Murphy's sign or jaundice on physical examination should not rule out this disease or accompanying biliary tract infection because a biliary-enteric fistula may be present. Thorough review of the radiologic images should be performed, since subtle details could be easily missed or dismissed, thus affecting the postoperative course. A CCF should alert the physician that another disease entity is present.
authors.affiliation: Department of Gastroenterology, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Jenn-Yuan
authors.initials: JY
authors.lastname: Kuo
authors.affiliation: Department of Critical Care Medicine, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Yeun Tarl Fresner Ng
authors.initials: YT
authors.lastname: Jao
mesh_terms: D000369:Aged, 80 and over; D001658:Biliary Fistula / Q000150:complications* / Q000175:diagnosis; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003108:Colonic Diseases / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005704:Gallbladder; D005706:Gallbladder Neoplasms / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications* / Q000175:diagnosis; D010212:Papilloma / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed