Cholecystoduodenal fistula

Case contributed by Mohamed Mahmoud Elthokapy
Diagnosis almost certain

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
ct

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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