Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 13 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.
● Biliary-enteric fistulas found in 0.2 to 5.0% of patients with biliary tract surgery for non-malignant disease (Surgeon 2010;8:67)
● 90% due to cholelithiasis, 10% due to penetrating peptic ulcers of stomach or duodenum
● Complications: gallstone ileus
● Mortality: 15%
● From gallbladder in 90%, biliary tract in 10%
● Usually to duodenum, also colon
● Gallstones cause inflammation and necrosis of gallbladder or bile duct wall, leading to intestinal adhesions, leading to fistula
● Abdominal pain, diarrhea, dyspeptic symptoms, nausea, and weight loss
● Most can be managed laparascopically
● Air within biliary tree by Xray, vomiting or passing a large gallstone
● 59 year old woman with cholecystocolic fistula (Saudi J Gastroenterol 2009;15:42)
Right transverse colon with gall stone in fistula
End of Gallbladder > Miscellaneous non-tumor > Fistula
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