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Summary
A patient with gallstones experienced abdominal blockage due to a fistula and a large calculus. The calculus was passed, resolving symptoms and healing the fistula, showcasing spontaneous recovery from cholelithiasis complications.
Area of Science:
- Gastroenterology
- Radiology
Background:
- Cholelithiasis (gallstones) can lead to severe complications, including bowel obstruction.
- Bilio-enteric fistulas are rare but serious complications of gallstone disease.
Observation:
- A female patient presented with acute abdominal occlusion secondary to cholelithiasis.
- Radiological imaging revealed a bilio-digestive fistula and jejuno-ileal dilation and hypotonia.
- A large cholesterol and calcium calculus was found impacted within the sigmoid colon.
Findings:
- Spontaneous passage of the impacted gallstone led to rapid symptom resolution, including pain and occlusion.
- Post-procedure cholangiocholecystography confirmed gallbladder normalization and fistula closure within 3 months.
Implications:
- This case highlights the potential for spontaneous resolution of complex biliary-enteric complications.
- It underscores the importance of comprehensive radiological assessment in diagnosing the cause of bowel obstruction.
- Successful non-surgical management of gallstone-induced fistula and obstruction is possible.