Gastric Outlet Obstruction arising from Xanthogranulomatous Cholecystitis accompanied by both Cholecystoduodenal and Cholecystocolonic Fistulas / 대한췌담도학회지

Xanthogranulomatous cholecystitis (XGC) is a rare type of chronic inflammation of the gallbladder characterized by focal or diffuse destructive inflammatory responses. Although it is a benign condition, its destructive course may lead to more aggressive outcomes of the gallbladder, such as local infiltration, fistula, stricture, and perforation as compared with other gallbladder inflammations. There are reports about XGC accompanied by cholecystoenteric fistula. However, XGC accompanied by more than one cholecystoenteric fistula is rare. We report a case of a 54-year-old man with gastric outlet obstruction arising from XGC, accompanied by cholecystoduodenal fisula and cholecystocolonic fistula, but without impacted gallstones.

Xanthogranulomatous Cholecystitis Complicated with Cholecystocolonic Fistula / 대한소화기내시경학회지

Xanthogranulomatous cholecystitis is an uncommon inflammatory disease of the gall baldder characterised by a focal or diffuse destructive inflammatory process. The pathogenesis is uncertain, but an inflammatory response to extravasated bile due to acute inflammation and obstruction is likely. Macroscopically, the gall bladder wall is invariably thickened, and extensive adhesions to adjacent organs are frequent. Clinically, xanthogranulomatous cholecystitis can mimic gall bladder carcinoma and radiologic differential diagnosis is extremely difficult. Fistula to skin and duodenum was reported. We report the first case of cholecysto-colonic fistula due to xanthogranulomatous cholecystitis.