Abstract
A cholecystogastric fistula is considered to be a rare entity. We report a case with a cholecystogastric fistula complicated by gallstone ileus. An 82-year-old man, who had taken a proton pump inhibitor for a gastric ulcer, presented with epigastralgia and vomiting. Abdominal CT showed air density and calcification in a small gallbladder. CT also revealed a calcified body, 5×3 cm in size, in the small bowel associated with a proximal dilation. The patient was initially treated conservatively with a long intestinal tube, but this failed to resolve the obstruction. Therefore, a laparotomy was done, and a gallstone 5×3 cm in size was found to be obstructing the jejunum. The gallbladder had created an adhesion between the pylorus and the round ligament. A cholecystogastric fistula was identified. Enterolithotomy combined with cholecystectomy and fistula closure was performed.
