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Cholecystocolonic Fistula with Malabsorption
- LOUIS J. ELSAS, M.D.; and
- TUVIA GILAT, M.D.New Haven, Connecticut
- Requests for reprints should be addressed to Louis J. Elsas, M.D., Yale-New Haven Hospital, 789 Howard Avenue, New Haven, Conn. 06411.
Excerpt
Cholecystocolonic fistula is the second most common fistula between the gallbladder and gastrointestinal tract and is found in 3 to 33% of reported series of internal biliary fistulae (1-10). Detailed descriptions of cholecystocolonic fistulae are quite rare, and we have been able to find only one case report in which the clinical picture and some of the laboratory data suggested malabsorption (11). We have been unable to find pertinent absorption studies in this condition before and after the oral administration of bile salts or surgical correction. When the common duct is completely obstructed, cholecystocolonic fistula results in a situation in
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgment
The authors wish to express their appreciation to Dr. Arthur R. Clemett for reviewing the X-ray material and to Dr. Michael Viola for his assistance in the care of the patient.
Summario in Interlingua
Un femina de racia blanc de 80 annos de etate se presentava al Hospital Yale-New Haven con le gravamines de debilitate e diarrhea. Ben que le prehistoria e le examine physic del patiente revelava nulle evidentia de morbo del vesica biliari, un clyster a barium demonstrava clarmente le presentia de un fistula cholecystocolonic. In plus, il esseva constatate que le patiente habeva malabsorption de grassia, caroteno, calcium, e d-xylosa, insimul con hypokaliemia e hypoprothrombinemia. Le hypokaliemia e le hypoprothrombinemia esseva corrigite per le administration parenteral de kalium e vitamina K. Aspiration duodenal monstrava nulle bile, e le fistula cholecystocolonic habeva producite un situation in le qual bile—ben que presente in le feces—non esseva disponibile pro absorption ad in le intestino tenue. Per consequente, sales biliari esseva administrate oralmente, e le malabsorption de caroteno, calcium, grassia, e d-xylosa esseva corrigite, con un melioration consequente in le symptomas del patiente.
Le syndrome clinic de fistula cholecystocolonic es revistate. Le importantia de sales biliari pro le absorption de grassia, caroteno, e vitamina D es discutite. Nulle satisfacente explication ha essite trovate pro le melioration del absorption de d-xylosa, e le autores nota lor desiro de obtener confirmation del these que le absentia de bile pote resultar in un defective absorption de d-xylosa.
Article and Author Information
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From the Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn., and the Medical Service of the Yale-New Haven Hospital, New Haven, Conn.
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This study was supported in part by grants AM-5156 and FR-3004, U. S. Public Health Service, Bethesda, Md.
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- Received March 24, 1965.
- Accepted May 18, 1965.
