PMC6039705_01
Dilatation of the biliary system including the intrahepatic ducts with coexisting pneumobilia, cholecystoduodenal fistulization can be appreciated with contracted irregular gallbladder outline containing air locules extending to the juxtapositioned duodenal lumen with a heterogenous enhancement at the site of the abnormal communication.
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An enhanced computed tomography scan of the abdomen was obtained that revealed dilatation of the biliary system including the intrahepatic ducts with coexisting pneumobilia, cholecystoduodenal fistulization with contracted irregular gallbladder outline containing air locules extending to the juxtapositioned duodenal lumen with a heterogenous enhancement at the site of the abnormal communication (Fig. 1).
Ectopically positioned hyperdense luminal structure, measuring about 3.5 x 3 cm in caliber at the sentinel jejunal segment suggestive of a gallstone resulting in distended small bowel dilataion with adjacent collapsed small and large bowel loops.
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Ectopically positioned hyperdense luminal structure, measuring about 3.5 x 3 cm in caliber at the sentinel jejunal segment suggestive of a gallstone resulting in distended small bowel dilataion with adjacent collapsed small and large bowel loops (Fig. 2).
Gallbladder stone impacted in a jejunal loop measuring about 3.5 x 3 cm.
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An enterolithotomy was performed over a healthy jejunal segment few centimeters proximal to the transition zone demonstrating an oval shaped stone measuring roughly 3.5 x 3 cm in size was removed via a longitudinal incision and the defect was closed primarily in a transverse fashion using an absorbable suture (Fig. 3).