A rare gastrointestinal bleeding due to a cholecystoduodenal fistula: a case report

BackgroundGastrointestinal bleeding from cholecystoduodenal fistula is rare. It is usually managed surgically, although a conservative approach is reported in isolated cases.Case presentationA 71-year-old male patient was admitted to the emergency department (ED) presenting melena associated with severe anemia, requiring a blood transfusion. An urgent upper endoscopy showed the intestinal orifice of a cholecystoduodenal fistula. This finding was confirmed by radiological examination and laparoscopy. Cholecystectomy and simultaneous excision of the fistula were successfully performed. As a result, a diagnosis of Mirizzi syndrome type Va was also made.ConclusionA cholecystoduodenal fistula orifice leading to gastrointestinal bleeding is difficult to diagnose without an endoscopic examination of the upper digestive tract. Following this first diagnostic step, a comprehensive patient examination should be conducted, specifically if a history of gallbladder lithiasis has been reported.