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Biliobiliary fistulas manifested by worsening liver function--a case report
Takashi Ishikawa1, Shun Yoshida, Hitoshi Sekido
1Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Kobayashi Clinic, Yokohama, Japan. tak55@med.yokohama.cu.ac.jp
Hepato-Gastroenterology
|July 9, 2005
Summary
Gallstones (cholecystolithiasis) can cause rare biliobiliary fistulas, leading to liver dysfunction. Surgical gallbladder removal successfully treated this case, highlighting a potential diagnostic clue for internal biliary fistulas.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Pathology
Background:
- Cholelithiasis, or gallstones, is a common condition.
- Biliary fistulas are abnormal connections between the biliary tree and other organs.
- Biliobiliary fistulas connecting the gallbladder directly to hepatic ducts are exceptionally rare.
Observation:
- A patient presented with worsening liver dysfunction attributed to cholecystolithiasis.
- Imaging did not reveal common bile duct dilation, complicating preoperative diagnosis.
- The gallbladder wall was noted to be thickened and shrunken.
Findings:
- A rare case of biliobiliary fistulas originating from the gallbladder and extending into the hepatic ducts was identified.
- Cholelithiasis was the underlying condition associated with the fistula formation.
- The patient underwent successful cholecystectomy with fistula closure using the gallbladder wall.
Implications:
- This case demonstrates that internal biliary fistulas can occur in cholecystolithiasis, even without common bile duct dilation.
- Thickened and shrunken gallbladder walls in the context of gallstones may indicate a potential for fistula formation.
- Early recognition and surgical intervention are crucial for managing such rare biliary anomalies and improving liver function.