Emergency laparotomy with Cholecystectomy was done. The surgical report showed disruptive calculus cholecystitis, a cholecystoduodenal fistula with impacted gallstone measuring about 5x5 cm diameter in the descending part of the duodenum obstructing its lumen. Subserotic cholecystectomy and excision of the fistula and extraction of the gallstone from the duodenum were performed.
The image above shows the removed gallstone.