case_images: PMC11792731_01
case_images: CT of the abdomen and pelvis and intraoperative findings. A) Arrow demonstrating retroperitoneal perforation with air and fluid around the duodenum and the cholecystoduodenal fistula on CT of the abdomen and pelvis. B) Intraoperative findings: gallbladder adhered to the duodenum at the site of the stricture and fistula.
case_images: cureus-0017-00000076942-i01.jpg
case_images: PMC11792731_01_cureus-0017-00000076942-i01.jpg
case_images: FIG1
case_images: Given her continued hemodynamic stability, she underwent an urgent computed tomography (CT) of the abdomen and pelvis, which revealed a retroperitoneal perforation with air and fluid around the duodenum and the presence of a cholecystoduodenal fistula (Figure 1A). The patient was taken emergently to the operating room for an exploratory laparotomy where the gallbladder with the gallstone was found to be inseparable from the first and proximal second portion of the duodenum (Figure 1B) at the site of her previously identified GOO.