case_images: PMC5465658_01
case_images: Coronal CT image showing a markedly distended and irregularly shaped intrahepatic gallbladder (red arrow) with surrounding edema.
case_images: crg-0011-0148-g01.jpg
case_images: PMC5465658_01_crg-0011-0148-g01.jpg
case_images: f1
case_images: It was difficult to distinguish where the gallbladder wall terminated and the hepatic parenchyma began, i.e., intrahepatic gallbladder (Fig. 1).
case_images: MR image (T2-weighted, axial) demonstrating marked thickening of the gallbladder wall and debris in the gallbladder (red arrow).
case_images: crg-0011-0148-g02.jpg
case_images: PMC5465658_01_crg-0011-0148-g02.jpg
case_images: f2
case_images: Magnetic resonance cholangiopancreatography confirmed a large hypo-enhancing gallbladder with multiple enhancing septations and thickened irregular wall, with invasion into the adjacent hepatic parenchyma as well as possible fistulization into the first portion of the duodenum/pylorus (Fig. 2).
case_images: Opening of the cholecystogastric fistula with purulence (red arrow); gastric antrum in the background.
case_images: crg-0011-0148-g03.jpg
case_images: PMC5465658_01_crg-0011-0148-g03.jpg
case_images: f3
case_images: Esophagogastroduodenoscopy demonstrated a cholecystogastric fistula through which the gallbladder was directly entered (Fig. 3).
case_images: Cholecystogastric fistula (left) and lumen of the gallbladder with exudative covering of wall (right).
case_images: crg-0011-0148-g04.jpg
case_images: PMC5465658_01_crg-0011-0148-g04.jpg
case_images: f4
case_images: A white exudate on the gallbladder wall and moderate purulence were noticed (Fig. 4).