Cholecysto - Duodenal Fistula with GI Obstruction and Perforation: A Rare Case Report

Dr. Dharm Patel, Dr. Jignesh Dave, Dr. Vidit Jethwa

Abstract: The Gastrointestinal obstruction (rarely GI perforation) is a serious complication of cholelithiasis due to the formation of a fistula from the gallbladder to the subjacent duodenum. The gallstones are usually large enough to cause intestinal obstruction, rarely cause GI perforation due to erosion. The distal ileum, close to the ileocecal valve, is the most common site of obstruction in these cases, where the luminal diameter is narrowed. This condition is currently responsible for 4% of all the cases of mechanical bowel obstruction. However, when considering a 65+ age group, the rate goes up to 25%. In conclusion, Gastrointestinal obstruction is a surgical emergency that, although rare, has high morbimortality rates. Here we present the case of a patient with an acute abdomen. Exploratory laparotomy was performed with Cholecystoduodenal Fistula repair in 1st part of duodenum with cholecystectomy with primary repair of jenunal perforation. The postoperative evolution was satisfactory without complications.

Keywords: Cholecystoduodenalfistula; Acute abdomen; Gastrointestinal obstruction, Jenunal perforation