A RARE CONNECTION: INSIGHTS INTO CHOLECYSTOGASTRIC FISTULA- A CASE REPORT AND LITERATURE REVIEW

Introduction: Cholecystoenteric fistulas are rare complications of gallstone disease, with cholecystogastric fistulas (CGF) being the rarest variant, accounting for only 2% of all bilioenteric fistulas. These unusual connections are typically discovered incidentally during surgery due to their non-specific clinical presentation, posing significant diagnostic challenges for clinicians. Case Presentation: A 33-year-old female presented with right-sided abdominal pain of 15 days duration without any specific aggravating or relieving factors. Clinical examination revealed a hard, mildly tender globular mass in the right hypochondrium that moved with respiration. Radiological investigations identified an irregular solid lesion in the gallbladder fundus abutting the anterior wall of the gastric antropylorus. Intraoperatively, a gallstone was found impacted at the anterior wall of the gastric antropylorus, forming a fistulous connection between the gallbladder and stomach. The patient underwent successful one-stage surgery comprising cholecystectomy with resection of the involved gastric margin and primary closure of the defect. Histopathological examination of the gastric margin was normal, and the patient recovered uneventfully. Although rare, cholecystogastric fistulas are associated with considerable morbidity a Conclusion: nd require prompt intervention. This case illustrates that a single surgical procedure consisting of stone removal, fistula repair, and cholecystectomy is a feasible treatment approach for patients with cholecystogastric fistulas.