The usual cause is an underlying bilio-enteric fistula between the gallbladder and duodenum (cholecystoduodenal fistula) through which the stone migrates into. Gallstone ileus is peculiar because it can take the form of a high intestinal obstruction followed by a low intestinal obstruction as the stone travels down the. Cholecystoduodenal fistulas usually are caused by gallstones, eroding through the contact point of the inflamed gallbladder with the adjacent bowel, in contrast.

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Images in clinical medicine. After that fistula occurs. Historically, abdominal radiograph demonstrating classical Rigler’s triad of bowel obstruction, pneumobilia, and an ectopic gallstone has been described in gallstone ileus.

It should be contemplated in elderly cholecstoduodenal that have a contracted gallbladder with numerous adhesions. Abstract Bouveret syndrome is an unusual complication of cholelithiasis which results in upper gastrointestinal obstruction due to a gallstone impacted in the duodenum through a bilio-enteric fistula.

A retrospective study fistla conducted to search for bilioenteric fistula in patients that underwent cholecystectomy at our hospital center due to cholelithiasis, cholecystitis, or cholangitis, within a 3-year time frame. However, the ectopic location of the gallstone within the intestinal lumen may be confused with an orthotopic location in a contracted gallbladder.


Per-operative extrication of the incriminating gall stone from the duodenum. Upper gastrointestinal GI endoscopy of the patient revealed a cholecystoduodenal fistula in the second part of duodenum. Cholecystoduodemal scan has been useful as an imaging modality for diagnosis of this condition.

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Support Radiopaedia and see fewer ads. Appearance on CT and cholecystoduodfnal gastrointestinal radiography before and after stone obturation. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.

Four patients, 2 men and 2 women, were identified with cholecystoduodenal fistula.

Cholecystoduodenal Fistula: A Case Report

He also gave history of unquantified weight loss since last 3 months. Select your fistua of interest to view the total content in your interested language. Factors favoring the biliary-enteric fistula formation include: After that fistula was visualized Figure 1. This article has been cited by other articles in PMC. Axial T2W image revealing cholecystoduodenal fistula marked with arrow. Sign in to save your search Sign in to your personal account.

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Cholecystoduodenal Fistula: A Case Report | Insight Medical Publishing

Two of the patients presented with acute cholangitis and 2 presented with bowel obstruction due to gallstone ileus. A 5-cm sized calculus was noted in the third part of duodenum beyond which the scope was not negotiable.

Indian J Radiol Imaging. Conclusion To conclude, Bouveret syndrome is an unusual and a rare complication of gallstone disease. Sign in to make a comment Sign in to your personal account. Bouveret’s syndrome in Melbourne. In addition, a secondary sign of presence of contrast in the gallbladder may be a pointer towards the diagnosis. The gallbladder is collapsed, thickened, and adherent to the second part of duodenum.


Thick slab MRCP demonstrating the cholecystoduodenal fistula between the collapsed gallbladder and second part of duodenum. Repeated attempts at endoscopic retrieval along with extracorporeal shock wave and mechanical lithotripsy proved fruitless and the patient was taken up for surgery. Treatment of cholecystoduodenal fistula in the era of laparoscopy. Indian J Radiol Imaging.

Fistula between gall bladder and gastrointestinal tractus occurs anywhere for example stomach, duodenum, and colon.