[Cholecistocolic fistula: an uncommon cause of lower gastrointestinal bleeding]

Cholecystocolic fistula is an uncommon biliary-enteric fistula with a variable clinical presentation that usually appears as a rare complication of gallstone disease. It can present with abdominal pain, nausea, weight loss, diarrhoea with or without associated steatorrhea, and dyspeptic symptoms. Rare cases have been reported with lower gastrointestinal haemorrhage and even with a gallstone ileous. The most useful techniques for diagnosis are CT, barium studies, and ERCP. We report a case of a cholecistocolic fistula in an elderly woman with multiple medical comorbidities that presented as lower gastrointestinal bleeding. She was explored with colonoscopy, abdominal CT and barium enema. She required a total of 4 units of whole blood and because of her comorbidities a decision was made not to proceed with invasive treatment. She had a good evolution and was asymptomatic two months later.