Malrotation-associated cholecystoduodenal fistula

Am J Case Rep. 2014 Jan 14:15:18-21. doi: 10.12659/AJCR.889903. eCollection 2014.

Abstract

Patient: Female, 16 FINAL DIAGNOSIS: Malrotation and cholecystoduodenal fistula Symptoms: Abdominal pain • anorexia • fever • nausea • vomiting

Medication: - Clinical Procedure: - Specialty: Gastroenterology and Hepatology.

Objective: Anatomical anomaly/variation.

Background: Cholecystoduodenal fistula (CDF) is the most common cholecystenteric fistula. It is a late complication of gallbladder disease with calculus and is mainly encountered in the elderly and females.

Case report: We report the case of a teenage patient with cholecystoduodenal fistula and malrotation. Direct plain abdominal x-ray demonstrated air in the biliary system. Computed tomography revealed CDF-associated with an anomaly of intestinal malrotation. She had gallstones (with a few stones in the gallbladder) and cholecystitis. CDF is caused by malrotation, and cholecystitis has not been reported before. In this regard our patient is the first and youngest reported case.

Conclusions: We suggest that CDF is probably a consequence of malrotation. The patient's clinical features and operative management are presented and discussed with current literature.

Keywords: cholecystitis; cholecystoduodenal fistula; malrotation.