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Key Clinical Message: Cholecystocolonic fistula occurring as a complication of colonic diverticular disease is a rarely encountered clinical entity in which the patient may remain asymptomatic or present with vague abdominal or systemic symptoms. Imaging studies are usually not very reliable or effective in detecting direct communication between gallbladder and colon. However, indirect signs such as pneumobilia, gallstones, gallbladder adherent to colon and colonic diverticulosis may help reach the diagnosis. Treatment of cholecystocolonic fistula in symptomatic patients is usually surgical. However, in asymptomatic patients or patients with risk factors and comorbidities, non‐surgical options such as conservative management or biliary stenting can be considered. [ABSTRACT FROM AUTHOR]

Key Clinical Message Cholecystocolonic fistula occurring as a complication of colonic diverticular disease is a rarely encountered clinical entity in which the patient may remain asymptomatic or present with vague abdominal or systemic symptoms. Imaging studies are usually not very reliable or effective in detecting direct communication between gallbladder and colon. However, indirect signs such as pneumobilia, gallstones, gallbladder adherent to colon and colonic diverticulosis may help reach the diagnosis. Treatment of cholecystocolonic fistula in symptomatic patients is usually surgical. However, in asymptomatic patients or patients with risk factors and comorbidities, non‐surgical options such as conservative management or biliary stenting can be considered.

Background: Cholecystoenteric fistulae are rare complications of gallstone disease, with a reported incidence of 0.5% to 0.9% of cholecystectomies. Cholecystoduodenal is the most common fistula followed by cholecystocolonic fistulae. Summary: We report a case of pneumobilia resulting from a combined cholecystoduodenal and cholecystocolonic fistulae treated with a laparoscopic subtotal cholecystectomy and open repair of the enteric fistulae. Conclusion: Combined cholecystoduodenal and cholecystocolonic fistulae are an extremely rare complication of gallstone disease, and meticulous preoperative planning and operative dexterity are needed to safely manage these unusual fistulae., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Fredrick J. Bohanon et al.)

Abstract Cholecystocolonic fistula is a rare condition often diagnosed intraoperatively, requiring an adequate set of knowledge and skills to allow safe intraoperative change of prior planned surgery and alleviate significant morbidity.

Cholecystocolonic fistula is a rare condition often diagnosed intraoperatively, requiring an adequate set of knowledge and skills to allow safe intraoperative change of prior planned surgery and alleviate significant morbidity. [ABSTRACT FROM AUTHOR]

We report the demonstration (for the first time to our knowledge) of a cholecysto-colonic fistula using Primovist® enhanced MRCP in a 74-year-old patient. We discuss the advantage of this newly emerged technique over traditional T2-weighted MRCP in this indication.