A case of gallstone ileus in gallbladder-duodenal fistula that was found during follow-up for cholelithiasis

Abstract

A 66-year-old man who was undergoing follow-up for cholelithiasis, suffered abdominal pain and nausea. Computed tomography (CT) showed a foreign object at the terminal ileum. On CT performed one week later, the foreign object had disappeared, but a fistula was found between the gallbladder and the duodenum. We started conservative treatment and CT showed that the foreign object moved to the rectum. We extracted the foreign object under lower endoscopy on the 10th day of the disease. Pathologic examination showed that the foreign object was a gallstone. His abdominal symptoms improved. On upper endoscopy, the fistula was observed in the lower wall of the duodenal bulb. He was discharged on the 19th day. Follow-up of the fistula was planned.