THE CLINICAL AND RADIOLOGICAL FEATURES OF CHOLECYSTOCOLIC FISTULAS

The clinical and radiological features of seven patients presenting wi th cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43-85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinic al course. Diarrhoea was the most common presenting symptom and the ty pical clinical features of gallbladder disease were absent. Cholangiti s occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). Tn only one patient was the diagnosis of biliary-intestinal fistula suspected on t he basis of the plain abdominal radiograph (Case 5). A diagnosis of ch olecystocolic fistula was established by barium enema (5 cases), endos copic retrograde cholangiopancreatography (ERCP) (1 case) and diagnost ic laparotomy (1 case). The only cause identified in this series was a cute or chronic cholecystitis.