Cholecystocolonic fistula: an incidental intraoperative discovery managed laparoscopically

Cholecystoenteric fistula is a rare complication of cholelithiasis, occurring in 3%-5% of patients with cholelithiasis. The symptoms are typically minimal and vague, with either acute or subacute presentations, rarely leading to bowel obstruction, and occasionally manifesting as chronic abdominal pain. In this case, a male patient in his early 30s presented with epigastric and right hypochondrial pain. On evaluation, he was diagnosed with gallstone disease and adenomyomatosis of the gallbladder. During laparoscopic cholecystectomy, a cholecystocolonic fistula was unexpectedly discovered. The fistula was managed laparoscopically using ENDOLOOP (prelooped chromic catgut ligature) ligation of the fistulous tract. The patient recovered without complications and was discharged on the third postoperative day. This case emphasises the importance of intraoperative vigilance and demonstrates a successful minimally invasive management approach.