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Cholecystoduodenal Fistula and Urosepsis in A Febrile Emergency Department Patient: A Case Report

Amna Nawaz¹, Denise Elizondo¹, Bushra Hussein¹

¹Duke University School of Medicine, Department of Emergency Medicine, Durham, North Carolina.

Clinical Practice and Cases in Emergency Medicine

|February 4, 2025

Abstract

Introduction:

Point-of-care ultrasound (POCUS) is a rapid bedside tool, particularly in undifferentiated emergency department patients. Point-of-care ultrasound can investigate potential intra-abdominal infections in febrile patients, especially in the elderly, who often present atypically without abdominal pain or localizing symptoms.

Case Report:

We highlight the important POCUS findings of cholecystoduodenal fistula and staghorn calculus in a febrile, elderly patient with dementia.

Conclusion:

Early recognition of cholecystoduodenal fistula and staghorn calculus using POCUS can expedite appropriate antibiotic and interventional treatment for improved patient outcomes.

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