CC BY-NC-ND 4.0 · Avicenna J Med 2022; 12(01): 034-037
DOI: 10.1055/s-0041-1739541
Case Report

The Curious Case of a Missing Gallbladder: An Unusual Presentation of a Cholecystoduodenal Fistula

Sarvani Surapaneni
1   Internal Medicine Department, Wayne State University, Detroit, Michigan, United States
,
2   Gastroenterology Division, University of Southern California, Los Angeles, California, United States
,
Michael K. Chiu
3   Department of Radiology, Wayne State University, Detroit, Michigan, United States
,
Alkis Zingas
3   Department of Radiology, Wayne State University, Detroit, Michigan, United States
,
4   Department of Surgery, Wayne State University, Detroit, Michigan, United States
,
Murray Ehrinpreis
5   Gastroenterology Division, Wayne State University, Detroit, Michigan, United States
› Author Affiliations
Funding None.

Abstract

Large gallstones could erode through gallbladder wall to nearby structures, causing fistulas, gastric outlet obstruction and gallstone ileus. They typically occur in elderly patients with comorbidities carrying therapeutic challenges. We present a case of a middle-aged woman who was thought to have symptomatic cholelithiasis. Extensive adhesions precluded safe cholecystectomy. While hepatobiliary iminodiacetic acid scan and magnetic resonance imaging with cholangiopancreatography (MRI-MRCP) failed to visualize the gallbladder, computed tomography (CT) was consistent with cholecystoduodenal fistula. A very large gallstone was seen endoscopically in the duodenum, which was broken down into pieces using a large stiff snare.

Note

This case study was presented as a poster at the 2020 Annual American College of Gastroenterology Meeting [virtual], 10/2020.


Authors' Contributions

The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and each author believes that the manuscript represents honest work. All authors provided substantial contributions to the concept, drafting, and final approval. This manuscript is a result of collaboration among GI, general surgery and radiology.




Publication History

Article published online:
02 December 2021

© 2021. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg 2007; 31 (06) 1292-1297
  • 2 Warren DJ, Peck RJ, Majeed AW. Bouveret's syndrome: a case report. J Radiol Case Rep 2008; 2 (04) 14-17
  • 3 van Hillo M, van der Vliet JA, Wiggers T, Obertop H, Terpstra OT, Greep JM. Gallstone obstruction of the intestine: an analysis of ten patients and a review of the literature. Surgery 1987; 101 (03) 273-276
  • 4 Halabi WJ, Kang CY, Ketana N. et al. Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Ann Surg 2014; 259 (02) 329-335
  • 5 Haddad FG, Mansour W, Deeb L. Bouveret's syndrome: literature review. Cureus 2018; 10 (03) e2299
  • 6 Doshi B, Yasuda I, Ryozawa S, Lee GH. Current endoscopic strategies for managing large bile duct stones. Dig Endosc 2018; 30 (Suppl. 01) 59-66
  • 7 Le Mouel JP, Thiebault H, Hakim S. Bouveret's syndrome. Clin Gastroenterol Hepatol 2019; 17 (06) e55
  • 8 Ramos GP, Chiang NE. Bouveret's syndrome. N Engl J Med 2018; 378 (14) 1335
  • 9 Philipose J, Khan HM, Ahmed M, Idiculla PS, Andrawes S. Bouveret's syndrome. Cureus 2019; 11 (04) e4414
  • 10 Osman K, Maselli D, Kendi AT, Larson M. Bouveret's syndrome and cholecystogastric fistula: a case-report and review of the literature. Clin J Gastroenterol 2020; 13 (04) 527-531
  • 11 Al-Habbal Y, Ng M, Bird D, McQuillan T, Al-Khaffaf H. Uncommon presentation of a common disease - Bouveret's syndrome: A case report and systematic literature review. World J Gastrointest Surg 2017; 9 (01) 25-36
  • 12 Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Br J Surg 1990; 77 (07) 737-742
  • 13 Doycheva I, Limaye A, Suman A, Forsmark CE, Sultan S. Bouveret's syndrome: case report and review of the literature. Gastroenterol Res Pract 2009; 2009: 914951
  • 14 Mavroeidis VK, Matthioudakis DI, Economou NK, Karanikas ID. Bouveret syndrome-the rarest variant of gallstone ileus: a case report and literature review. Case Rep Surg 2013; 2013: 839370
  • 15 Park SH, Lee SW, Song TJ. Another new variant of Bouveret's syndrome. World J Gastroenterol 2009; 15 (03) 378-379