Presentation
Right upper abdominal pain with vomiting. Gallbladder not visualized on ultrasound.
Patient Data
Contracted gallbladder with thick and regular wall and intraluminal gas. No evidence of gallstones. Gas within the intra-and extrabiliary tree (pneumobilia). Probable fistulous tract connecting the gallbladder and the duodenum.
Irregular thickening with the enhancement of the gastric cardia (an upper GI endoscopy was requested).
Nonenhanced CT with oral contrast (performed 48 hours later) with an annotated image showing contrast within the gallbladder lumen and opacification of the fistulous tract (Red arrows) in keeping with a cholecystoduodenal fistula.
Case Discussion
CT features of a cholecystoduodenal fistula well-visualized mainly on nonenhanced CT with oral contrast.
At surgery, there was a perforated duodenal ulcer with cholecystoduodenal fistula.
Unable to process the form. Check for errors and try again.