Imaging Case of the Week 217 Answer

The CT shows a thickening of the gall bladder wall, with evidence of air within. Adjacent to the gall bladder is the duodenum with a gall stone in the lumen. This patient had developed a fistulous connection between the gall bladder and the duodenum, thereby resulting in Bouveret syndrome.

Bouveret syndrome is a rare complication of cholelithiasis that results in upper gastrointestinal obstruction due to a gall stone impacted in the duodenum.

cholecystoduodenal fistula

 

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