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摘要
La f赤stula colecistoc車lica es un tipo poco com迆n de f赤stula bilioent谷rica que tiene una presentaci車n cl赤nica variable y que generalmente aparece como complicaci車n de la enfermedad liti芍sica biliar. Puede manifestarse en forma de dolor abdominal, n芍useas, p谷rdida de peso, diarrea con o sin esteatorrea asociada, cl赤nica disp谷ptica y m芍s raramente como hemorragia digestiva baja, colangitis de repetici車n o incluso como un ileo biliar. Las t谷cnicas m芍s 迆tiles para el diagn車stico son el TC abdominal, los estudios baritados y la colangiopancreatograf赤a retr車grada endosc車pica (CPRE). Describimos el caso de una mujer de edad avanzada, pluripatol車gica, con f赤stula colecistoc車lica, que se present車 en forma de hemorragia digestiva baja. Fue estudiada mediante colonoscopia, TC abdominal y enema de bario. Durante el ingreso requiri車 transfusi車n de 4 concentrados de hemat赤es, desestim芍ndose el tratamiento invasivo debido a su comorbilidad de base. Evolucion車 favorablemente, con resoluci車n espontanea del cuadro. Dos meses despu谷s permanec赤a asintom芍tica. Cholecystocolic fistula is an uncommon biliary-enteric fistula with a variable clinical presentation that usually appears as a rare complication of gallstone disease. It can present with abdominal pain, nausea, weight loss, diarrhoea with or without associated steatorrhea, and dyspeptic symptoms. Rare cases have been reported with lower gastrointestinal haemorrhage and even with a gallstone ileous. The most useful techniques for diagnosis are CT, barium studies, and ERCP. We report a case of a cholecistocolic fistula in an eldery woman with multiple medical comorbidities that presented as lower gastrointestinal bleeding. She was explored with colonoscopy, abdominal CT and barium enema. She required a total of 4 units of whole blood and because of her comorbidities a decision was made not to proceed with invasive treatment. She had a good evolution and was asymptomatic two months later.
