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29 October 2014 : Case report  Taiwan

Gallbladder Papillomatosis and Cholecystocolonic Fistula: A Rare Combination

Challenging differential diagnosis, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Jenn-Yuan KuoABCDEF, Yeun Tarl Fresner Ng JaoABCDEF

DOI: 10.12659/AJCR.891190

Am J Case Rep 2014; 15:466-470

Abstract

BACKGROUND: Biliary papillomatosis (BP) with sole involvement of the gall bladder or gall bladder papillomatosis (GBP) is very rare. Biliary-enteric fistula, particularly the cholecystocolonic fistula (CCF) type, is also very rare. The combination of both types of lesions in a single patient has never previously been reported in the English literature.

CASE REPORT: We report herein the case of an 81-year-old woman who was diagnosed with both disease entities, which occurred in a cause-and-effect relationship. She underwent resection of the gall bladder with closure of the fistula, and was discharged improved afterwards.

CONCLUSIONS: GBP is a premalignant condition that warrants extensive resection. An absent Murphy’s sign or jaundice on physical examination should not rule out this disease or accompanying biliary tract infection because a biliary-enteric fistula may be present. Thorough review of the radiologic images should be performed, since subtle details could be easily missed or dismissed, thus affecting the postoperative course. A CCF should alert the physician that another disease entity is present.

Keywords: Biliary Fistula - diagnosis, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Colonic Diseases - diagnosis, Diagnosis, Differential, Gallbladder, Gallbladder Neoplasms - diagnosis, Intestinal Fistula - diagnosis, Papilloma - diagnosis, Tomography, X-Ray Computed

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923