Cholecystoduodenocolic fistula with recurrent gallstone ileus

J. C. Pangan, R. Estrada and R. Rosales

The combination of cholecystoduodenocolic fistula with gallstone ileus is rarely seen. To our knowledge, there have only been six previous reports with these findings. A 66-year-old woman's condition was diagnosed preoperatively as small-bowel obstruction and communications between the gallbladder, duodenum, and colon. The small-bowel obstruction was successfully relieved by removing a large gallstone from the midileum, leaving the inflammatory mass in the right upper quadrant undisturbed. Three weeks later the small-bowel obstruction recurred. At reoperation two gallstones were found obstructing the midileum and were removed. The cholecystoduodenocolic fistula was dissected and the duodenum and colon were repaired. A cholecystostomy was done. The patient recovered and has been well four years later.