Cholecystocolonic Fistula Presenting With Gallstone Ileus: A Report of a Rare Surgical Case

TL;DR

A rare case of cholecystocolonic fistula causing gallstone ileus is reported, highlighting the diagnostic and surgical challenges involved.

Contribution

This paper presents a rare clinical case of CCF with gallstone ileus and emphasizes the importance of imaging and surgical intervention.

Findings

A 60-year-old female presented with symptoms of gallstone ileus caused by a cholecystocolonic fistula.

Surgical intervention included enterolithotomy, cholecystectomy, and colonic resection with successful postoperative recovery.

Imaging studies were crucial in diagnosing the condition and guiding the surgical approach.

Abstract

Cholecystocolonic fistula (CCF) is a rare entity resulting from chronic gallstone disease. Here we describe a 60-year-old female who presented with abdominal distension, colicky pain, and constipation for a period of five days. Imaging studies revealed pneumobilia and small bowel obstruction. Exploration via laparotomy revealed a 3.5 cm gallstone lodged in the terminal end of the ileum and a fistulous tract from the gallbladder to the hepatic flexure of the colonic bowel. Surgical intervention consisted of enterolithotomy, cholecystectomy, and colonic resection with primary anastomosis. Fortunately, postoperative recovery was smooth and uneventful. Preoperative diagnostic challenges, the salience of imaging, and surgical intervention are emphasized in this case. As a brief background review, we searched the literature to outline the spectrum of the disease and the advancing methods to overcome CCF.

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