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Volume 7, Issue 3 (2026)
J Clinic Care Skill 2026, 7(3): 1001-1013 |
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History
Received: 2026/10/6 | Accepted: 2026/10/10 | Published: 2026/08/19
Received: 2026/10/6 | Accepted: 2026/10/10 | Published: 2026/08/19
How to cite this article
Niakan M, Gheysari S, Hasanshahi M, Kuhsari E, Yousefinya A. Repair of a rare case of ileus gallstone Cholecystoduodenal fistula with Gastroduodenal anastomosis. J Clinic Care Skill 2026; 7 (3) :1001-1013
URL: http://jccs.yums.ac.ir/article-1-524-en.html
URL: http://jccs.yums.ac.ir/article-1-524-en.html
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Authors
Mohammadhadi Niakan 
, Somayeh Gheysari *1 , Mehdi Hasanshahi , Emad Kuhsari , Amirhossein Yousefinya
, Somayeh Gheysari *1 , Mehdi Hasanshahi , Emad Kuhsari , Amirhossein Yousefinya
1- , somayeh.gh65@yahoo.com
Abstract (2 Views)
Aim: To report a rare case of gallstone ileus associated with a cholecystoduodenal fistula and describe its diagnosis and surgical management.
Method: A 66-year-old man with no history of illness or surgery presented to a hospital in Shiraz with abdominal pain, bloating, nausea, vomiting, severe constipation, and lack of gas and stool excretion for 5 days. Ultrasound diagnosed a fistula between the gallbladder and duodenum. The patient had stable vital signs, abdominal distension, and slight tenderness without guarding or rebound. CT scan of the abdomen and pelvis with oral contrast demonstrated an obstructive pattern, and the patient became a candidate for surgery.
Finding: Exploratory laparotomy revealed a 2 × 2 cm gallstone at the end of the ileum causing proximal dilation and distal collapse extending to the cecum. A 1 × 1 cm fistula was detected between the initial part of the duodenum and gallbladder, with a 3 × 3 cm stone in the gallbladder infundibulum. Cholecystectomy was performed, followed by removal of the first part of the duodenum and attachment of the second part of the duodenum to the gastroduodenal anastomosis. Enterotomy was performed and the ileal stone was removed. On the fourth postoperative day, the patient tolerated diet and had normal gas and stool passage; he was discharged on the fifth day in good general condition with normal tests.
Conclusion:Cholecystoduodenal fistula results from long-term inflammation due to gallstones. Detailed history and assessment of previous problems and diseases are required for accurate surgical planning and prevention of severe complications.
Method: A 66-year-old man with no history of illness or surgery presented to a hospital in Shiraz with abdominal pain, bloating, nausea, vomiting, severe constipation, and lack of gas and stool excretion for 5 days. Ultrasound diagnosed a fistula between the gallbladder and duodenum. The patient had stable vital signs, abdominal distension, and slight tenderness without guarding or rebound. CT scan of the abdomen and pelvis with oral contrast demonstrated an obstructive pattern, and the patient became a candidate for surgery.
Finding: Exploratory laparotomy revealed a 2 × 2 cm gallstone at the end of the ileum causing proximal dilation and distal collapse extending to the cecum. A 1 × 1 cm fistula was detected between the initial part of the duodenum and gallbladder, with a 3 × 3 cm stone in the gallbladder infundibulum. Cholecystectomy was performed, followed by removal of the first part of the duodenum and attachment of the second part of the duodenum to the gastroduodenal anastomosis. Enterotomy was performed and the ileal stone was removed. On the fourth postoperative day, the patient tolerated diet and had normal gas and stool passage; he was discharged on the fifth day in good general condition with normal tests.
Conclusion:Cholecystoduodenal fistula results from long-term inflammation due to gallstones. Detailed history and assessment of previous problems and diseases are required for accurate surgical planning and prevention of severe complications.