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February 11, 1956


JAMA. 1956;160(6):463-464. doi:10.1001/jama.1956.02960410039009a

Of all the types of spontaneous fistulas reported, the cholecystogastric is one of the most infrequent. The case herein presented is one in which the presence of a gallstone in the stomach was diagnosed preoperatively by radiological examination. A review of the literature indicates the most frequent type of biliary fistula is the cholecystoduodenal, followed by the cholecystocolic fistula. Among the infrequent forms of biliary fistulas are the choledochoduodenal, choledochocolic, cholecystojejunal, and cholecystogastric. Although the diagnosis is most often made at postmortem examination, the roentgen diagnosis of a biliary fistula can frequently be made, as illustrated in the following case.

A 54-year-old white male was admitted to the Michael Reese Hospital, Chicago, on Sept. 25, 1954, with complaints of vomiting and tarry stools of several days' duration. The vomiting was preceded by a short period of nausea. The vomitus was bile-stained and consisted of partially digested food particles. There had