# A rare case of a cholecysto-duodenocolonic fistula secondary to cholelithiasis

## TL;DR

This paper reports a rare case of a combined cholecysto-duodenocolonic fistula caused by gallstones, highlighting the challenges in diagnosing and managing such a condition.

## Contribution

The novelty lies in presenting a rare simultaneous occurrence of cholecystoduodenal and cholecystocolonic fistulas due to cholelithiasis.

## Key findings

- Cholecysto-duodenocolonic fistulas are extremely rare and challenging to diagnose.
- Gallstones were identified as the causative factor in this case.
- The case emphasizes the need for a high index of suspicion in managing complex biliary fistulas.

## Abstract

Internal biliary fistula is a rare but well-known complication of cholelithiasis. It is a notoriously challenging entity to diagnose and manage. Gallstones are often the causative factor in the formation of a cholecystoenteric fistula, with the most common internal biliary fistula being a cholecystoduodenal fistula followed by a cholecystocolonic fistula. Rarely, do these fistulae exist simultaneously. Here, we present an uncommon case of cholecysto-duodenocolonic fistula.