RARE OBSERVATION: INCOMPLETE CHOLECYSTOGASTRIC FISTULA WITH SIMULATION OF SUBMUCOSAL TUMOR OF THE ANTRAL PART OF THE STOMACH

Relevance. Cholelithiasis is one of the most common gastrointestinal diseases. In case of long-term stone carriage, some patients experience complications in the form of biliodigestive anastomoses. Incomplete fistulas are relatively rare and their diagnosis is sometimes difficult due to the diverse clinical picture.

Case descriptions.  The article presents a clinical observation of a rare complication of cholelithiasis - incomplete cholecystogastric fistula with simulation of a submucosal tumor of the antrum of the stomach. A 72-year-old female patient was admitted for planned surgical treatment for chronic calculous cholecystitis. The gallstone was detected more than 10 years ago, the next exacerbation of the disease occurred 1 month ago after eating fatty and fried foods. According to multispiral computed tomography, signs of a space-occupying lesion of the pyloric part of the stomach with signs of infiltrative growth into the wall of the gallbladder were obtained. During surgery, an incomplete cholecystogastric fistula was established. Cholecystectomy was performed. A defect in the wall of the antrum of the stomach was detected, where a calculus measuring 15x10x10 mm was found in the submucosal layer, simulating a space-occupying lesion of the antrum of the stomach. The defect in the wall of the stomach was sutured. The postoperative period was favorable. Wound healing by primary intention. The patient was discharged in satisfactory condition on the 8th day. During the control examination after 3 months, the condition was satisfactory.

Conclusion. The peculiarity of this clinical observation: difficulties in diagnosing a rare variant of biliodigestive anastomosis - an incomplete cholecystogastric fistula with a simulation of a submucosal tumor of the antrum of the stomach.

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