A Case of Xanthogranulomatous Cholecystitis Associated with a Cholecystocolonic Fistula

Abstract

A 76-year-old man presenting with abdominal pain and vomiting consulted the previous hospital, and an abdominal ultrasonography revealed an enlarged gallbladder. He was referred to our hospital, and was diagnosed as acute cholecystitis by an abdominal CT scan. After conservative treatment, he was scheduled to undergo cholecystectomy. Although, he had no cholecystitis symptoms, preoperative abdominal CT scan revealed aggravated cholecystitis, and MRI demonstrated a fistula between the gallbladder and transverse colon. After additional fasting and antibiotic treatment, we performed surgery for cholecystocolonic fistula. At surgery the fistula was confirmed, and open subtotal cholecystectomy and partial transverse colon resection was carried out. There were no postoperative complications, and he was discharged on 15^th postoperative day. The histological diagnosis of the resected specimens was xanthogranulomatous cholecystitis (XGC). We report this very rare case of XGC associated with cholecystocolonic fistula.