Cholecystocolonic fistula

Case contributed by Dr Vitalii Rogalskyi

Presentation

Dull abdominal pain, constipation.

Patient Data

Age: 75 years
Gender: Female

CT Abdomen and Pelvis

CT

The gallbladder is shrunken, with intraluminal air bubbles. The hepatic flexure of colon adheres to gallbladder with visible fistulous tract. 

Sigmoid diverticulosis: sigmoid wall thickening, many diverticula (non-inflamed) and luminal narrowing. There is ovoid foreign body within sigmoid lumen in keeping with a migrated gallbladder stone.

Left adrenal adenomas, bilateral simple renal cysts, duodenal diverticula

Annotated Images

Annotated image

First image: fistula between gallbladder and ascending colon.

Second image: migrated gallstone impacted within sigmoid colon lumen.

Case Discussion

Classical case of cholecystocolonic fistula. This is rarely diagnosed before surgery. It may lead to liver abscess or large bowel obstruction (no signs of either in our case).

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