Tennessee Medicine E-Journal


Choledocholithiasis usually presents with signs and symptoms of cholangitis. Rarely, patients with choledocholithiasis present with biliary enteric fistulas (cholecystoduodenal, cholecystocolonic and cholecystogastric). Women in their sixth and seventh decade of life are most commonly affected. While symptoms of cholecystocolonic fistula are nonspecific, diarrhea is present in more than 70 percent of cases. Careful evaluation of common bile duct should be performed in all cases of cholecystocolonic fistula, as removal of stone leads to regression of fistula in the majority of cases. We present a case of an elderly woman referred for evaluation of fecal incontinence, weight loss and massive pneumobilia.