PMC3512245_01
Contrast enhanced coronal reformatted MDCT image shows the cholecystoduodenal fistula (thick-white arrow) and calculus (thin-black arrow) in dilated third part of duodenum. Dilated fluid filled stomach is also seen (star).
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fig1
Stomach and duodenum were dilated (Figures 1 and 2).
Sagittal reformatted MDCT image shows the fistula (red arrow) lying anteriorly and the calculus (white arrow) with a hyperdense rim.
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fig2
Stomach and duodenum were dilated (Figures 1 and 2).
Peroperative image shows the excised fistula (arrow).
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fig3
The fistulous tract was excised, and the 2nd part of duodenum was opened simultaneously (Figure 3).
Calculus (arrow) is seen through the duodenotomy incision.
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fig4
Duodenotomy was extended, and a black impacted stone was retrieved from the same site measuring 4 x 2.5 cm (Figures 4 and 5).
The hardshelled gallstone after surgery.
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fig5
Duodenotomy was extended, and a black impacted stone was retrieved from the same site measuring 4 x 2.5 cm (Figures 4 and 5).