title: Cholecystocolonic fistula mimicking acute cholecystitis diagnosed unequivocally by computed tomography.
abstract: Cholecystocolonic fistula is an uncommon potential complication of cholecystitis found intraoperatively in 0.06-0.14 % of patients undergoing cholecystectomy and 0.1-0.5 % of autopsy series. Although cholecystocolonic fistula is the second most common cholecystoenteric fistula, second only to cholecystoduodenal fistula, it is diagnosed preoperatively in only 7.9 % of patients. Failure to preoperatively diagnose cholecystocolonic fistula places surgeons in precarious positions, as they may be forced to convert a seemingly routine cholecystectomy to a more sophisticated procedure coupled with adhesiolysis, colonic suturing, or colonic resection. We report a young patient who presented to the emergency department with complaints indicative of acute cholecystitis; however, preoperative ultrasound was suggestive of a cholecystoenteric fistula. Computed tomography and pathology were pathognomonic with clear visualization of the cholecystocolonic fistulous tract.
authors.affiliation: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA, jchick@partners.org.
authors.forename: Jeffrey Forris Beecham
authors.initials: JF
authors.lastname: Chick
authors.forename: Nikunj Rashmikant
authors.initials: NR
authors.lastname: Chauhan
authors.forename: Vera Ashley
authors.initials: VA
authors.lastname: Paulson
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Adduci
mesh_terms: D000328:Adult; D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging*; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005402:Fistula / Q000000981:diagnostic imaging*; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging*; D008297:Male; D014057:Tomography, X-Ray Computed