Abstract
A case of spontaneous cholecystogastric fistula was reported. A 43 year old man complaining of right hypochondralgia and diarrhea was diagnosed as sepsis due to acute cholecystitis and admitted to the hospital. Abdominal ultrasonogra-phy on the 2nd day revealed distended gall bladder with a stone impacted in the neck of bladder. Although initial treatment was successful with medical improvement of the general condidions, surgical operateion was postponed because of the patients refusal and serial ultrasonography was performed to follow up the clinical course vigously. Ultrasono-graphy in the 11th hospital week revealed a low echogenic mass nearby collapsed gall bladder. Barium fluoroscopy of the stomach showed a protruded lesion at the greater curvature of the antrum. Spontaneous cholecystogastric fistula was suspected and gas-troendoscopy revealed an elevated lesion like a submucosal tumor at the same location with the orifice of fistula at the top of the lesion. Cholecystogastric fistula was confirmed by fistulography via catheter inserted endoscopically into the orifice. Cholecystestomy and closure of the fistula was performed and the patient was discharged with good hospital course.
