Diagnosis of Cholecysto-Colonic Fistula Using Gadoxetic Acid – Magnetic Resonance Cholangiography

Enterobiliary fistula is an unusual complication of cholelithiasis. It has also been reported in ulcerative colitis, abdominal trauma, Crohn’s disease, and malignancy of the bowel, the head of the pancreas, and the biliary tract. Cholecysto-duodenal fistulas are the most frequent (75%), and only 10–20% are cholecysto-colonic. The majority of patients with cholecysto-colonic fistulae are females and elderly. The typical presentations include diarrhea (most common), nausea, abdominal pain, weight loss, and dyspeptic symptoms [1]. Malabsorption could result when the fistula alters the normal bile acid circulation. The asymptomatic form is not rare. Pre-operative identification is complex and often doubtful. The definitive diagnosis is typically achieved during surgery.