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Am Surg ; 89(8): 3605-3608, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-36959693

RESUMEN

Bilioenteric fistulae are rare and difficult to manage complications of chronic cholecystitis. While cholecystoduodenal and cholecystocolic fistulae are more common, a cholecystoappendiceal fistula is an extremely rare finding. We report the presentation and operative management of a 59-year-old male with cholecystoappendiceal fistula and associated abscess in the gallbladder fossa. The patient was appropriately resuscitated, the abscess drained by interventional radiology, and after a complete workup, underwent a laparoscopic appendectomy and cholecystectomy. Pathology revealed moderately differentiated appendiceal adenocarcinoma requiring a right hemicolectomy with cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). He has recovered well postoperatively with no complications. This case highlights the importance of having a very high index of suspicion for underlying malignancy when managing a fistula of any kind. To the best of our understanding, this is only the second reported case of a cholecystoappendiceal fistula.


Asunto(s)
Adenocarcinoma , Neoplasias del Apéndice , Fístula , Hipertermia Inducida , Neoplasias Peritoneales , Masculino , Humanos , Persona de Mediana Edad , Quimioterapia Intraperitoneal Hipertérmica , Procedimientos Quirúrgicos de Citorreducción , Absceso/cirugía , Neoplasias Peritoneales/patología , Neoplasias del Apéndice/complicaciones , Neoplasias del Apéndice/terapia , Neoplasias del Apéndice/patología , Adenocarcinoma/terapia , Adenocarcinoma/cirugía , Fístula/cirugía , Colectomía
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