case_images: PMC3707284_01
case_images: A plain abdominal X-ray suspecting the presence of air in the gallbladder (arrow).
case_images: CRIM.SURGERY2013-839370.001.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.001.jpg
case_images: fig1
case_images: The abdominal X-ray was suspicious for presence of air in the gallbladder (Figure 1).
case_images: Small arrow showing the presence of air in an intrahepatic bile duct. Large arrow showing gastric dilatation.
case_images: CRIM.SURGERY2013-839370.002.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.002.jpg
case_images: fig2
case_images: The stomach was found with mild dilatation (Figures 2, 3, 4, and 5).
case_images: Contrast and air inside the gallbladder (arrow).
case_images: CRIM.SURGERY2013-839370.003.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.003.jpg
case_images: fig3
case_images: The stomach was found with mild dilatation (Figures 2, 3, 4, and 5).
case_images: Dilatation of the duodenum (arrow).
case_images: CRIM.SURGERY2013-839370.004.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.004.jpg
case_images: fig4
case_images: The stomach was found with mild dilatation (Figures 2, 3, 4, and 5).
case_images: A gallstone in the 2nd to 3rd part of the duodenum (arrow).
case_images: CRIM.SURGERY2013-839370.005.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.005.jpg
case_images: fig5
case_images: The stomach was found with mild dilatation (Figures 2, 3, 4, and 5).
case_images: Five minutes after intake of the oral contrast all the anatomic elements are well visualised: (a) the gallbladder filled with contrast, (b) the cystic duct filled with contrast, (c) the cholecystoduodenal fistula, (d) a duodenal diverticulum of the 3rd part filled with contrast, and (e) a large gallstone impacted on the 2nd to 3rd part of the duodenum.
case_images: CRIM.SURGERY2013-839370.006.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.006.jpg
case_images: fig6
case_images: The gallbladder, the cystic duct and the cholecystoduodenal fistula as well as a duodenal diverticulum of the 3rd part were well visualised (Figures 6 and 7).
case_images: Fifteen minutes after intake of the oral contrast (a) the evacuation of the gallbladder is well seen as well as (b) the dilatation of the filled up with contrast duodenum proximally to the impacted gallstone and (c) the slight passage of the gastrografin distally to the gallstone in the 4rth part and jejunum.
case_images: CRIM.SURGERY2013-839370.007.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.007.jpg
case_images: fig7
case_images: The gallbladder, the cystic duct and the cholecystoduodenal fistula as well as a duodenal diverticulum of the 3rd part were well visualised (Figures 6 and 7).
case_images: A cholecystoduodenal fistula orifice noticed in the superior duodenal wall (arrow).
case_images: CRIM.SURGERY2013-839370.008.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.008.jpg
case_images: fig8
case_images: The fistula orifice was seen (Figure 8) as well as the proximal side of the gallstone (Figure 9). 
case_images: The proximal side of a large gallstone impacted in the 2nd to 3rd part of the duodenum (arrow).
case_images: CRIM.SURGERY2013-839370.009.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.009.jpg
case_images: fig9
case_images: The fistula orifice was seen (Figure 8) as well as the proximal side of the gallstone (Figure 9). 
case_images: The gallstone located in the first part of the jejunum after successful milking right before jejunotomy (arrow).
case_images: CRIM.SURGERY2013-839370.011.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.011.jpg
case_images: fig11
case_images: With gentle milking movements distal removal was achieved in the first part of the jejunum right after the ligament of Treitz (Figure 11).
case_images: The extraction of the gallstone right after the ligament of Treitz (arrows).
case_images: CRIM.SURGERY2013-839370.012.jpg
case_images: PMC3707284_01_CRIM.SURGERY2013-839370.012.jpg
case_images: fig12
case_images: A jejunotomy and successful removal of the gallstone were performed (Figure 12).