Abstract

JORGE, João Xavier et al. Bilio-digestive fistulae of lithiasic origin: A report of 3 cases. J Port Gastrenterol. [online]. 2013, vol.20, n.3, pp.119-122. ISSN 0872-8178.  https://doi.org/10.1016/j.jpg.2012.07.002.

Spontaneous bilio-digestive fistulae are infrequent. We report three cases. Case 1: A 59 year old male, was admitted to the Emergency Department with complaints of abdominal pain, hematoquesia and pallor. The haemoglobin was 8.4 g/dl. Colonoscopy and upper gastrointestinal endoscopy were normal. He was given blood transfusion and subsequently discharged. Eighteen days later, he was readmitted to the Emergency Department with the same complaints. The exams were normal and after a transfusion, he was discharged. He was again admitted to the Emergency Department after six days. During his hospitalization he had two episodes of hematoquesia. The colonoscopy revealed a blood clot in the hepatic angle. An urgente surgery was made and revealed a cholecistocolonic fistulae, vesicular lithiasis and hemobilia. Case 2: A 74 year old male was admitted with to the Emergency Department with a history of melenas with a Hb of 9.7 g/dl. The upper gastrointestinal endoscopy revealed gastric and duodenal erosions and blood. The colonoscopy showed edematous and congested mucosal folds the splenic angle of the descending colon. He was given blood transfusions and subsequently discharged. Nearly 45 days later, the patient presented to the Emergency Department complaining of difficulty in evacuating stools. The proctologic examination revealed a petrous object in the rectum which was manually removed under anesthesia. The object was a large billiary stone. Case 3: A 75 year old male, with obstructive jaundice and bulbar deformation was admitted to the hospital for an ERCP. The CT had revealed a dilatation of intra and extra hepatic biliary tree and aerobilia. During the ERCP, just above the papilla, a small orifice draining bile was observed along with a calculus at the end of the choledocus. Conclusions: It were 3 cases of biliodigestive fistulas secondary to gallstones.

Keywords : Fistulae; Biliodigestive; Biliary lithiasis.

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