Gastro-cholecysto-colic fistula. Case report of an idiopathic case, and management approach

A 71-year-old lady presented with a 4-week-history of epigastric pain, feculent vomiting, diarrhoea and weight-loss. On subsequent investigations, she was found to have a complex gastro-cholecysto-colic fistula with no clear underlying aetiology. The only abnormality both macroscopically and microscopically was ulceration and inflammation in the colon. However, this was not pathognomonic of inflammatory bowel disease, and (gastric) acid-induced inflammation is an alternative explanation. Herein we present her case, her comprehensive evaluation, her successful surgical management and a review of the relevant literature.