CC BY-NC-ND 4.0 · Avicenna J Med 2022; 12(01): 034-037
DOI: 10.1055/s-0041-1739541
Case Report

The Curious Case of a Missing Gallbladder: An Unusual Presentation of a Cholecystoduodenal Fistula

Sarvani Surapaneni
1   Internal Medicine Department, Wayne State University, Detroit, Michigan, United States
2   Gastroenterology Division, University of Southern California, Los Angeles, California, United States
Michael K. Chiu
3   Department of Radiology, Wayne State University, Detroit, Michigan, United States
Alkis Zingas
3   Department of Radiology, Wayne State University, Detroit, Michigan, United States
4   Department of Surgery, Wayne State University, Detroit, Michigan, United States
Murray Ehrinpreis
5   Gastroenterology Division, Wayne State University, Detroit, Michigan, United States
› Author Affiliations
Funding None.


Large gallstones could erode through gallbladder wall to nearby structures, causing fistulas, gastric outlet obstruction and gallstone ileus. They typically occur in elderly patients with comorbidities carrying therapeutic challenges. We present a case of a middle-aged woman who was thought to have symptomatic cholelithiasis. Extensive adhesions precluded safe cholecystectomy. While hepatobiliary iminodiacetic acid scan and magnetic resonance imaging with cholangiopancreatography (MRI-MRCP) failed to visualize the gallbladder, computed tomography (CT) was consistent with cholecystoduodenal fistula. A very large gallstone was seen endoscopically in the duodenum, which was broken down into pieces using a large stiff snare.


This case study was presented as a poster at the 2020 Annual American College of Gastroenterology Meeting [virtual], 10/2020.

Authors' Contributions

The manuscript has been read and approved by all the authors, the requirements for authorship have been met, and each author believes that the manuscript represents honest work. All authors provided substantial contributions to the concept, drafting, and final approval. This manuscript is a result of collaboration among GI, general surgery and radiology.

Publication History

Article published online:
02 December 2021

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