Biliodigestive fistula in a cholecystectomized patient with mirizzi syndrome
Journal Title: Más Vita - Year 2022, Vol 4, Issue 4
Abstract
Introduction:Biliary fistulas after an operation are difficult to manage, as in cases of obstruction or malignancy. It can present from a bile leak without clinical repercussions and with spontaneous resolution to cause a septic condition with risk of death. Because it is a complication with various etiologies and presentations, its treatment is a challenge. Objective:To study a clinical case of biliodigestive fistula in a cholecystectomy patient with Mirizzi Syndrome. Materials and methods:Clinical case study. Results:76-year-old patient, hypertensive with a surgical history of laparoscopic cholecystectomy 6 months ago. With a clinical picture of 72 hours of evolution, characterized by burning pain in the right hypochondrium, irradiating towards the mesogastrium, nausea, vomiting; generalized jaundiced tint is observed that progresses in the last month. The bilioenteric fistula has a low reported incidence between 0.15 and 8%; It is a very rare complication of residual cholelithiasis due to the little specificity of the symptoms and signs of this condition. Preoperative diagnosis is difficult and is made in most cases during surgery for the existence of long-term residual choledocholithiasis8. The etiology of these stones is related to those coming from the gallbladder, not identified during cholecystectomy or, as previously mentioned, in relation to bile stasis of the bile duct itself. Conclusion:The biliary enteric fistula is a complication of gallstones, although its incidence is not very marked, it exists andmust be taken into account, especially in cholecystectomy patients previously diagnosed with Mirizzi syndrome or not. 9 Despite important technical advances, biliary complications continue to be linked to violations of the basic principles of surgery: clear diagnosis, patient preparation, adequate exposure, technique, and postoperative care
Authors and Affiliations
Tatiana Giomara Gómez García
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