Xanthogranulomatous cholecystitis and cholecystoduodenal fistula formation associated with total parenteral nutrition in a six year old child.

Abstract:

:A unique complication of florid xanthogranulomatous cholecystitis with cholecystoduodenal fistula formation is described in a 6 yr old male. The patient, who had a short gut syndrome, had been maintained on lifelong total parenteral nutrition (TPN) following extensive neonatal ischemic bowel necrosis secondary to gastroschisis. Endoscopic duodenal mucosal biopsy demonstrated a granulomatous inflammatory infiltrate surrounding bile casts suggesting the possibility of a fistula between the biliary tract and duodenum. Additional clinical and radiological evidence of a cholecystoduodenal fistula prompted surgical intervention. At laparotomy the gallbladder was firmly bound to the duodenum by dense fibrous adhesions. Histologic examination showed xanthogranulomatous inflammation in association with fragments of bile that were present both within the gallbladder wall and within a fistulous tract in the adjacent connective tissue.

journal_name

Pathology

journal_title

Pathology

authors

Byard RW,Thorner PS,Cutz E,Filler RM,Durie P

doi

10.3109/00313029009086671

subject

Has Abstract

pub_date

1990-10-01 00:00:00

pages

239-41

issue

4

eissn

0031-3025

issn

1465-3931

journal_volume

22

pub_type

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