Presentation
Dull abdominal pain, constipation.
Patient Data
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.
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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