慢性下痢を主訴とした胆嚢結腸瘻の1例

概要

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Cholecystocolic fistula is a relatively rare disease. In this paper, we reported a case of cholecystocolic fistula preoperatively diagnosed by PTC. A 55-year-old male was admitted to our hospital complaining of chronic diarrhea. In biochemical examinations, enzymes such as ALP, γ-GTP and LAP were found to be increased. The lack of bile and decrease of maximal sodium bicarbonate concentration were observed in duodenal aspirate by PStest. Endoscopic retrograde cholangiography (ERC) showed complete obstruction of the common bile duct. Colonofiberscopic findings revealed yellowish fluid resembling bile around the hepatic flexure. Furthermore, contrast medium injected by PTC was found in the area of the heptic flexure. The existence of fistula was confirmed operatively, and the patient's diarrheaic condition disappeared after surgery.