Chronic Gallstone Disease Presenting as Cholecystoduodenal Fistula

Abstract

Cholecystoduodenal fistula (CDF) is the most common cholecystoenteric fistula. It is a late complication of gallbladder disease with calculus and is mainly encountered in the elderly and females. We report the case of a 60 years’ female patient with cholecystoduodenal fistula and gallstones. She had recurrent attacks of abdominal pain with anorexia and vomiting. Ultrasound abdomen demonstrated air in the biliary system. Computed tomography abdomen revealed pnemobilia and CDF tract. We did cholecystectomy and repair of CDH tract through Modified Graham’s repair. This case report suggests the importance of knowing the biliary anatomy through pre-op Magnetic resonance cholongio pancreatography (MRCP) or MRI abdomen and planning definitive procedure for bilioenteric fistulas. The patient’s clinical features and operative management are presented and discussed with current literature.