Presentation
Abstract The authors present four cases of internal biliary fistulae (IBF) identified on hepatobiliary scintigraphy. All of the cases share common history of external biliary leak closure. [ncbi.nlm.nih.gov]
In addition, a number of new imaging modalities are presented in this new edition. [books.google.com]
Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. All the patients underwent surgical treatment and the diagnostic and therapeutic management of each of them was analyzed. [revistagastroenterologiamexico.org]
Entire Body System
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Physician
[…] logo-32 logo-40 logo-60 New England Journal of Medicine NEJM Group Follow Us Facebook Twitter Instagram YouTube LinkedIn Blog Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with NEJM Group [nejm.org]
"a tour de force in terms of knowledge and effort" — The New England Journal of Medicine "the foremost liver book in the world" — The Journal of the American Medical Association "beautifully produced" —Hepatology Over the past 56 years, thousands of physicians [books.google.com]
Physicians involved in the management of patients with UGIB should entertain the possibility of a biliary-enteric fistula as a possible cause, particularly in patients with risk factors for gallstone disease. [omicsonline.org]
J Coll Physicians Surg Pak. 2005 Nov. 15(11):726-7. [Medline]. Dutriaux C, Maillard H, Prophette B, Catala M, Célerier P. [Spontaneous cholecystocutaneous fistula]. Ann Dermatol Venereol. 2005 May. 132(5):467-9. [Medline]. [emedicine.medscape.com]
The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. [webmedcentral.com]
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Wound Infection
Two wound infections, three bile leakages and three mortalities were observed. [ncbi.nlm.nih.gov]
infection if your doctor thinks your fistula may close on its own. [healthline.com]
Local extension usually results in wound infection. Distant bacterial seeding may manifest as splenic and hepatic abscess or endocarditis. [sites.google.com]
The use of nasogastric decompression and preoperative antibiotics is strongly recommended to minimize the risks of aspiration and postoperative wound infection. [clinicalgate.com]
Gastrointestinal
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Acute Abdomen
Nine patients underwent emergency laparotomy with a pre-operative diagnosis of acute abdomen. In the remaining three patients, elective laparoscopic cholecystectomy was converted to open surgery after identification of IBF. [ncbi.nlm.nih.gov]
These latter are toxic and sick with an acute abdomen. They require prompt resuscitation and laparotomy with lavage and either repair or exteriorization of the defect ( 33 ). [ptolemy.ca]
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Hematochezia
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself [nejm.org]
Liver, Gall & Pancreas
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Biliary Colic
colic, jaundice and cholangitis. [ 3 ] Intrabiliary rupture is reported to be seen in a range of 1-17% in such cases. [ 4 ] Cyst diameter of 7.5 cm and above is an independent factor that is associated with a high risk of biliary-cyst communication. [oapublishinglondon.com]
Musculoskeletal
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Fracture
Seat belt fracture with late development of an enterocolic fistula in a child. A case report. Spine 1999; 24(11):1151-1155. (22) Rijhwani A, Sunil I, Rijhwani A, Sunil I. Colonic fistula complicating electric burns--a case report. [ptolemy.ca]
Workup
Colonoscopy
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Polyps
MOST COMMON pseudotumor of GB What develops on GB in Cholesterolosis (strawberry GB) May contain cholesterol stones 2 Types of Cholesterol Stones : Flat plaque-like formation on mucosal wall, cholesterol polyp Symptoms of Cholesterolosis Same as those [quizlet.com]
[…] proctitis with fistula 2016 2017 2018 2019 Billable/Specific Code K51.213, ICD-10-CM Diagnosis Code K51.313 Ulcerative (chronic) rectosigmoiditis with fistula 2016 2017 2018 2019 Billable/Specific Code K51.313, ICD-10-CM Diagnosis Code K51.413 Inflammatory polyps [icd10data.com]
Treatment
An interdisciplinary reference book for the diagnosis and treatment of gallbladder and bile duct diseases With recent developments in the management of hepatobiliary diseases including liver transplantation, this new edition aids all members of the team [books.google.com]
Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself [nejm.org]
Treatment of these complex injuries is quite challenging and for many years surgical management has been considered the treatment of choice. [jdeonline.in]
AVP has also been used for the treatment ofesophago-pleural fistulae (assisted with endoscopy) ( 11 ), ureteral occlusion for vescicovaginal fistula ( 12 ), and treatment of intraperitoneal bile leak ( 13 ). [kjronline.org]
Prognosis
Prognosis is frequently related to early recognition, management of any comorbid conditions, and careful selection of treatment modalities. [nature.com]
Prognosis Prognosis is generally good. However, given that most patients with this condition are elderly, potential coexisting medical problems may complicate surgical intervention. [emedicine.medscape.com]
GBC is a relatively rare neoplasm which is associated with a poor prognosis, as it is often diagnosed in an advanced stage due to its nonspecific clinical presentation [24]. [graphyonline.com]
Prognosis The outcome of gastrointestinal fistulae has changed dramatically over the years with the introduction of intensive care and the provision of nutritional support. [ptolemy.ca]
Acute pancreatitis: Value of CT in establishing prognosis. Radiology 1990;174:331-6. 39. Matos C, Cappeliez O, Winant C, Coppens E, Devière J, Metens T. MR imaging of the pancreas: A pictorial tour. Radiographics 2002;22:e2. 40. [jdeonline.in]
Etiology
Gallstones are the primary etiologic agent in most internal biliary-enteric fistulas. [surgerysearch.blogspot.com]
Especially, chronic cholecystitis with GB stones is considered in about 75% of major etiology. Our case is also related with chronic cholecystitis. [astr.or.kr]
External biliary fistulae, in turn, can be further subdivided based on etiology into spontaneous, therapeutic, traumatic, and iatrogenic fistulae. [emedicine.medscape.com]
The etiology of biliary-enteric fistulas is yet to be clearly established. [omicsonline.org]
[…] thickness off GB wall w/ a stone in the area of the GB neck or cystic duct; edema found within the GB wall Normal wall thickness ,3mm MOST COMMON form of GB inflammation * Recurrent inflammatory changes in Gb (recurring attacks of acute cholecystitis) Etiological [quizlet.com]
Epidemiology
It's divided into three sections on anatomy, pathophysiology, and epidemiology; diagnostic and therapeutic approaches including the latest therapeutic modalities; and specific conditions. Includes more than 250 illustrations for rapid reference. [books.google.com]
Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology [brainscape.com]
Despite some epidemiological data to support this, experimental models have failed to replicate the carcinogenetic process. It is thus difficult at the present time to firmly conclude whether gallstones are the cause of GBC. [graphyonline.com]
[…] can cause chronic cholecystitis and may predispose the patient to spontaneous cholecystocutaneous fistula. [13] Polyarteritis nodosa with gallbladder vasculitis and steroid use causing immunosuppression also may be associated with the condition. [13] Epidemiology [emedicine.medscape.com]
Pathophysiology
It's divided into three sections on anatomy, pathophysiology, and epidemiology; diagnostic and therapeutic approaches including the latest therapeutic modalities; and specific conditions. Includes more than 250 illustrations for rapid reference. [books.google.com]
Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am. 1996 Oct; 76 (5):1009–1018. [ PubMed ] [ Google Scholar ] Donner CS. Pathophysiology and therapy of chronic radiation-induced injury to the colon. [ncbi.nlm.nih.gov]
Pathophysiology The cystic duct or gallbladder is almost always obstructed in patients with spontaneous cholecystocutaneous fistula. [emedicine.medscape.com]
Etiology and Pathophysiology Small intestinal fistulas can form in a number of ways. Enterocutaneous fistulas most commonly follow postoperative complications and are often the result of technical errors at the time of an abdominal procedure. [sites.google.com]
View Article PubMed Google Scholar Hernandez C, Heuman D, Vlahcevid ZR: Pathophysiology of disease associated with deficiency of bile acids. [bmcsurg.biomedcentral.com]
Prevention
CONCLUSION: Cholecystectomy has to be performed in early stage in the patients who were diagnosed as cholelithiasis to prevent the complications like IBF which is seen rarely. [ncbi.nlm.nih.gov]
Conversion to open surgery should be considered early when the anatomy is not clear to prevent iatrogenic injury. [file.scirp.org]
To prevent additional complications and fatal consequences, early diagnosis and adequate treatment are essential. [kjim.org]
In order to perform differential diagnosis with malignancy and prevent the enteral perforation from ischemic change of remnant enteric fistula, laparoscopic procedure is not feasible [ 5 ]. [astr.or.kr]
[…] close on their own when: your infection is controlled your body is absorbing enough nutrients your overall health is good only a small amount of gastric fluid is coming through the opening Your treatment will focus on keeping you well-nourished and preventing [healthline.com]