Presentation
Epigastric pain, nausea, fever, and vomiting as well as jaundice in an old patient with a previous diagnosis of calcular cholecystitis on ultrasound studies 10 years prior.
Patient Data
Age: 75 years
Gender: Male
From the case:
Cholecystoduodenal fistula
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Axial C+ arterial phase
Irregular-shaped gallbladder with thick wall and intraluminal gas. No evidence of radiodense gallstones. Gas within the intra-and extrahepatic biliary tree (pneumobilia). Probable fistulous tract connecting the gallbladder and the duodenum.
Case Discussion
Cholecystoduodenal fistulas represent a complication of neglected cholelithiasis and are the most common type of entero-biliary fistulous communication.
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