An Unusual Presentation of Cholecystoduodenal Fistula: Abdominal Pain out of Proportion to Exam

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" An Unusual Presentation of Cholecystoduodenal Fistula: Abdominal Pain out of Proportion to Exam "
McCreery, Ryan; Meigh, Matthew

Document Type	:	AL
Record Number	:	928119
Doc. No	:	LA82z2f1tw
Language of Document	:	English
Main Entry	:	McCreery, Ryan; Meigh, Matthew
Title & Author	:	An Unusual Presentation of Cholecystoduodenal Fistula: Abdominal Pain out of Proportion to Exam [Article]\ McCreery, Ryan; Meigh, Matthew
Title of Periodical	:	Clinical Practice and Cases in Emergency Medicine
Volume/ Issue Number	:	3/3
Date	:	2019
Abstract	:	Cholecystoduodenal fistula (CDF) is a rare complication of gallbladder disease. Clinical presentation is variable, and preoperative diagnosis is challenging due to the non-specific symptoms of CDF. We discuss a 61-year-old male with a history of atrial fibrillation who presented with severe abdominal pain out of proportion to exam. The patient was diagnosed promptly and successfully managed non-operatively. This case presentation emphasizes the need to maintain a broad differential diagnosis for abdominal pain out of proportion to exam, with the possibility of a biliary-enteric fistula as a possible cause. It also stresses the importance of a multimodality imaging approach to arrive at a final diagnosis.