Fístula colecisto-duodenal asintomática en una paciente con diabetes mellitus e hipotiroidismo primario: presentación de un caso / Asymptomatic cholecystoduodenal fistula in patient with diabetes mellitus and primary hypothyroidism: report of a case

ABSTRACT

The case of a 60-year-old woman with diabetes mellitus type II and primary hypothyroidism, who presented a clinical picture compatible with intestinal obstruction is reported. An abdominal sonogram revealed acute calculous cholescystitis and ileus. A plain film of the abdomen showed dilatation of small bowel loops. She underwent celiotomy, once stabilized, and gallstone ileus + cholecystoduodenal fistula were diagnosed intraoperatively. Resection of the ischemic segment of distal jejunum and the stone, cholecystectomy and primary repair of the fistula were performed. In spite of the systemic complications (metabolic, cardiovascular and pulmonary), that appeared postoperatively, the patient had a favorable outcome. This patient had an acute calculous cholecystitis anda spontaneous biliary-enteric fistula with intestinal obstruction, without preveious symptoms of biliary tract disease preceding the episode of bowel obstruction