Cholecysto-colic Fistula, A Rare Complication of Chronic Gallstone Disease: A Case Report and Review of Literature

Abstract

Background: Cholecystocolic fistula (CCF) is a rare internal biliary–enteric fistula occurring as a late complication of chronic gallstone disease. Because its symptoms are often vague and nonspecific, the condition is frequently underdiagnosed and commonly identified only during surgery or advanced imaging. Case Summary: We describe an elderly male who presented with nonspecific upper abdominal symptoms and was ultimately diagnosed with CCF. Imaging modalities, including CT and MRCP, played a key role in suggesting the presence of a fistulous communication. Intraoperatively, a cholecystocolic fistula was confirmed, necessitating conversion to open cholecystectomy with excision of the tract and primary colonic repair. The patient recovered uneventfully. Conclusion: Although uncommon, CCF should be considered in patients with chronic biliary symptoms and atypical imaging findings. Early suspicion and accurate preoperative assessment allow safer surgical planning. When recognized and managed appropriately, patient outcomes are generally excellent.