Cholecystocolonic fistula video presentation.

Ali M.S.; Matcovici M.; Alizai N.

Cholecystocolonic fistula video presentation.

All Authors

Ali M.S.

Matcovici M.

Alizai N.

LTHT Author

Ali, Muhammad Saad
Matcovici, Melania
Alizai, Naved

LTHT Department

Leeds Children's Hospital
Paediatric Surgery

Publication Date

2025

Item Type

Conference Abstract

Subject

PAEDIATRICS , ROBOTIC SURGICAL PROCEDURES , ABDOMINAL PAIN , APPENDECTOMY , CHOLECYSTECTOMY , FISTULA , GALLBLADDER DISEASES , GALLSTONES

Abstract

Aim: Cholecystocolonic fistulas are rare, even in adults. There are no case reports in children. We present a case of cholecystocolonic fistula in a paediatric patient, managed robotically. Method(s): Patients' clinical notes were reviewed and a literature review was conducted. Result(s): A 12-year-old boy presented acutely with one day history of right upper quadrant (RUQ) abdominal pain and loose stools. Appendicitis was suspected clinically, but required confirmation. Initial multiple Ultrasound examinations and then a CT suggested gallbladder pathology, with perforation and fistulation into the colon and retro-ascending colon appendix, with the tip lying close to gallbladder. Appendicitis was suspected as the initiating pathology. Patient was managed with antibiotics. He developed RUQ collection. A pigtail catheter was inserted, which drained ''dirty'' colour bile. The patient was admitted electively after 6 weeks for robotic exploration. Surgery revealed that the catheter was in the colon, macroscopically normal appendix, a contracted gallbladder attached to the colon and the cholecystocolonic fistula had closed. The patient underwent removal of drain, robotic repair of the colonic hole, repair of the previous fistula site at hepatic flexure, cholecystectomy and appendicectomy, with complete recovery and discharge after 4 days postoperatively. Conclusion(s): This case illustrates the difficulty in diagnosing and managing cholecystocolonic fistula. Even after investigations it was not clear if the initiating reason was appendicitis. The most likely cause, in this case was gallstone cholecystitis perforating into large bowel.