536 Conservative Management of the Colonic Gallstone

Abstract A 74-year-old woman presents with a 7-day history of increasing lower abdominal pains and reduced bowel movements; resulting in absolute constipation.Twenty-four hours prior to admission she also had symptoms nauseous significant distention. Her past medical included; diverticulitis, type 2 diabetes, hypercholesterolemia, an ultrasound scan 2005 confirming gallstones, but no previous surgery.She was initially treated for obstruction CT arranged. showed 4.5 cm gallstone mid-sigmoid colon cholecystocolonic fistula. She booked colonoscopy±laparotomy, on the morning her planned procedure repeatedly opened bowels. Subsequent colonoscopy negative repeat confirmed stone longer within gastrointestinal tract. Several case reports have clearly documented presence cholocystocholic fistula leading sigmorectal from gallstones. These reports, however, all implied that management should primarily be laparotomy. Although has been trialled, few cases appear successful conversion laparotomy high. This report highlights role conservative colonic avoiding morbidity mortality associated +/- resection.