Abstract
A 50-year-old man visited our hospital with the chief complaints of abdominal pain and vomiting. An abdominal CT revealed ileus and pneumobilia, and the patient was admitted. A gastroduodenography performed during insertion of the ileus tube revealed a cholecystoduodenal fistula. Upper gastrointestinal endoscopy was performed and an incarcerated piece of gall-stone was taken out from the fistula. DIC-CT was performed for evaluation of the biliary tract, which revealed a filling defect at the site of obstruction of the small intestine, and gall-stone ileus was strongly suspected. An urgent operation was performed and another piece of a broken gall-stone was taken out from the small intestine. No operation for the cholecystoduodenal fistula was performed as the biliary tract could not be clearly visualized by radiologic examination. Four weeks later, the cholecystoduodenal fistula was closed endoscopically. The patient was discharged without symptoms and has been under close follow-up without operative surgery.
