Endoscopic Management of an Unusual Biliary-Enteric Fistula

Oncology, Gastroenterology and Hepatology Reports,2013,2,1,30-31.
Published:January 2016
Type:Case Report
Author(s) affiliations:

Douglas G. Adler MD, FACG, FASGE, AGAF

University of Utah School of Medicine, Department of Internal Medicine, Division of Gastroenterology


A 65 year old man underwent laparoscopic cholecystectomy. Five days later, he developed severe right upper quadrant pain, fevers, and hyperbilirubinemia. He also developed a single episode of melena that was self limited. A HIDA scan was performed and appeared to show a bile leak but was atypical in appearance with contrast entering the bowel via what appeared to be an unusual route. CT scan did not reveal a clear biloma and no evidence of bile collecting in the abdomen was seen. Based on the HIDA scan, ERCP was performed. ERCP initially appeared to disclose a bile leak from the cystic duct remnant. Read more...