case_images: PMC6159182_01
case_images: Non-contrast CT abdomen and pelvis. Air is demonstrated in the biliary tree. This was initially attributed to post sphincterotomy pneumobilia.
case_images: bjrcr.20170038.g001.jpg
case_images: PMC6159182_01_bjrcr.20170038.g001.jpg
case_images: f1
case_images: Pneumobilia was also noted due to prominence of the hepatic biliary tree (Figure 1).
case_images: The arrow marks the location of the choledochoduodenal fistula. A continuous low density tract can be appreciated between the contracted gallbladder and the adjacent duodenum.
case_images: bjrcr.20170038.g002.jpg
case_images: PMC6159182_01_bjrcr.20170038.g002.jpg
case_images: f2
case_images: An addendum was added to the CT report, suggesting that the appearances were indicative of a gallstone ileus from a choledochoduodenal fistula (Figure 2) with a non-calcified gallstone possibly being present at the transition point in the left iliac fossa (Figure 3).
case_images: The arrow is marking the transition point in the left iliac fossa and what is likely an obstructing non-calcified gallstone. Gas can be appreciated within the gallstone. Following surgical removal, this gallstone measured 41 x 25 mm.
case_images: bjrcr.20170038.g003.jpg
case_images: PMC6159182_01_bjrcr.20170038.g003.jpg
case_images: f3
case_images: An addendum was added to the CT report, suggesting that the appearances were indicative of a gallstone ileus from a choledochoduodenal fistula (Figure 2) with a non-calcified gallstone possibly being present at the transition point in the left iliac fossa (Figure 3).