S-60 A Rare Case of Cholecystogastric Fistula Developed in a Patient with Early Gastric Cancer = S-60 A Rare Case of Cholecystogastric Fistula Developed in a Patient with Early Gastric Cancer

다국어 초록 (Multilingual Abstract)

Cholecystoenteric fistulas, including cholecystogastric, cholecystoduodenal, and cholecystocolonic ones, are the rare complications of long-standing cholelithiasis. In terms of cholecystogastric type, there are only a few reports worldwide. A 55-year-old woman initially visited a local clinic due to intermittent epigastric soreness. She underwent esophagogastroduodenoscopy (EGD) and was diagnosed with early gastric cancer (EGC) based on forceps biopsy revealing tubular adenocarcinoma. She was referred to our hospital for the management of EGC. When she visited to our clinic, she had no fever and abdominal pain. Physical examination and laboratory findings were unremarkable. EGD revealed EGC at the mid-body lesser curvature side and subepithelial mass with central ulcer-like lesion at the antrum greater curvature side. From the ulcer, pus-like discharge was draining repetitively. Culture study for the discharge confirmed that there were Escherichia coli, Klebsiella pneumonia, and Streptococcus sanquis. Abdominal computed tomography scan showed that she had a chronic calculous cholecystitis and a passed gallstone through cholecystogastric fistula. She was treated with ciprofloxacin medication, and underwent radical subtotal gastrectomy and cholecystectomy. To the best of our knowledge, this report describes very rare case of cholecystogastric fistula developed in a patient with EGC and chronic calculous cholecystitis.