Gas in the Gallbladder: A Case Of Gallbladder Adenocarcinoma Causing Cholecystoenteric Fistula Identified On Ultrasound.
ePoster
Authors: Alexander Shinnerl, Indiana University School of Medicine Supriya Chittajallu, Indiana University School of Medicine James Wilcox, Indiana University School of Medicine
Cholecystoenteric fistula is a rare pathology resulting from the development of an abnormal connection between the gallbladder and gastrointestinal tract, most commonly caused by cholelithiasis. While up to 5% of patients with cholelithiasis may develop CEF, other etiologies are important to be aware of. This includes gallbladder neoplasia, which carries a remarkably poor prognosis if not identified early in the disease course. In this case, a 75-year-old woman presented to the emergency room with acute on chronic abdominal pain on her right side. Multiple imaging modalities including ultrasound, CT scans, and MRCP were crucial in determining the diagnosis, as CEF presents non-specific signs and symptoms. This patient's thorough workup revealed suspected neoplasia as the etiology, and this case demonstrates imaging that clinicians should be suspicious of in complicated patients. We present this case of CEF to highlight the value of ultrasound as a preliminary diagnostic imaging tool.