Malrotation-associated cholecystoduodenal fistula

PATIENT Female, 16 FINAL DIAGNOSIS: Malrotation and cholecystoduodenal fistula Symptoms: Abdominal pain • anorexia • fever • nausea • vomiting MEDICATION - Clinical Procedure: - Specialty: Gastroenterology and Hepatology. OBJECTIVE Anatomical anomaly/variation. BACKGROUND Cholecystoduodenal fistula (CDF) is the most common cholecystenteric fistula. It is a late complication of gallbladder disease with calculus and is mainly encountered in the elderly and females. CASE REPORT We report the case of a teenage patient with cholecystoduodenal fistula and malrotation. Direct plain abdominal x-ray demonstrated air in the biliary system. Computed tomography revealed CDF-associated with an anomaly of intestinal malrotation. She had gallstones (with a few stones in the gallbladder) and cholecystitis. CDF is caused by malrotation, and cholecystitis has not been reported before. In this regard our patient is the first and youngest reported case. CONCLUSIONS We suggest that CDF is probably a consequence of malrotation. The patient's clinical features and operative management are presented and discussed with current literature.