Gallstone Bezoar Following Cholecystogastric Fistula: a Rare Sequelae of Cholelithiasis

Abstract

Cholecystogastric fistula is a rare biliary-enteric fistula with a variable clinical presentation. Despite modern diagnostic tools, a high index of suspicion is needed to diagnose it preoperatively. Stone migration into stomach forming gallstone bezoar is very rare. Stones more than 2.5 cm are likely to cause obstruction. We report a case of gallstone bezoar of size 9×5 cm lying in the stomach with a small fistulous opening in the prepyloric region of the stomach. Patient was thoroughly investigated and successfully treated with retrieval of bezoar and cholecystectomy.

Upper Gastrointestinal Manifestation of Bezoars and the Etiological Factors: A Literature Review

“…In most cases, the gallstone enters the duodenum through a cholecystoduodenal fistula followed by retrograde migration to the stomach. Small stones are generally eliminated via the stools, and stones measuring more than 2.5 cm are likely to cause obstruction [54]. The most common clinical manifestation is an acute obstruction, either at the duodenum bulb, causing pyloric obstruction, or at the ileum, causing gallstone ileus.…”