Carcinoma of the Gallbladder Associated with Spontaneous Cholecysto-gastric Fistula, Report of a Case Michio Maruyama 1 1Division of Surgery, Tokyo Metropolitan Komagome Hospital pp.908-914
Published Date 1988/8/25
DOI https://doi.org/10.11477/mf.1403108378
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 Spontaneous cholecysto-gastric fistula is rare among the enterobiliary fistulas. We encountered a case of carcinoma of the gallbladder associated with an old spontaneous cholecysto-gastric fistula. The patient was a 72-year-old Japanese man who had had a history of severe epigastric pain about 30 years previously. This suggests that the cholecysto-gastric fistula occurred at that time. Cholecystectomy with partial resection of the stomach around the fistula was performed. Macroscopically, the mucosal surface of the fundus of the resected gallbladder was irregular and granular. Histologically, carcinoma of the gallbladder was revealed at the fundus, adjacent to the gastric mucosa at the cholecysto-gastric fistula. The carcinoma had penetrated the muscle bundle at only one portion, and the serosa of the gallbladder was intact. The past history and fibrosis without inflammatory cell infiltration at the fistula indicate that the carcinoma occurred in the gallbladder with the cholecysto-gastric fistula. Microscopically, the gastric mucosa of the resected specimen showed no remarkable change. This is a very important case in regard to carcinogenesis of the gallbladder.

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