{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:24:46Z","timestamp":1761845086967},"reference-count":4,"publisher":"California Digital Library (CDL)","issue":"3","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Cholecystoduodenal fistula (CDF) is a rare complication of gallbladder disease. Clinical presentation is variable, and preoperative diagnosis is challenging due to the non-specific symptoms of CDF. We discuss a 61-year-old male with a history of atrial fibrillation who presented with severe abdominal pain out of proportion to exam. The patient was diagnosed promptly and successfully managed non-operatively. This case presentation emphasizes the need to maintain a broad differential diagnosis for abdominal pain out of proportion to exam, with the possibility of a biliary-enteric fistula as a possible cause. It also stresses the importance of a multimodality imaging approach to arrive at a final diagnosis.<\/jats:p>","DOI":"10.5811\/cpcem.2019.4.42686","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T01:32:38Z","timestamp":1564623158000},"page":"305-306","source":"Crossref","is-referenced-by-count":2,"title":["An Unusual Presentation of Cholecystoduodenal Fistula: Abdominal Pain out of Proportion to Exam"],"prefix":"10.5811","volume":"3","author":[{"given":"Ryan","family":"McCreery","sequence":"first","affiliation":[{"name":"Orange Regional Medical Center, Department of Emergency Medicine, Middletown, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Meigh","sequence":"additional","affiliation":[{"name":"Orange Regional Medical Center, Department of Emergency Medicine, Middletown, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"ref0","unstructured":"Glenn F, Reed C, Grafe WR.\u00a0Biliary enteric fistula.\u00a0Surg Gynecol Obstet.\u00a01981;153(4):527\u201331."},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Chowbey PK, Bandyopadhyay SK, Sharma A, et al.\u00a0Laparoscopic management of cholecystoenteric fistulas.\u00a0J Laparoendosc Adv Surg Tech A.\u00a02006;16(5):467\u201372.\u00a0","DOI":"10.1089\/lap.2006.16.467"},{"key":"ref2","unstructured":"Sharma A, Sullivan M, English H, et al. Laparoscopic repair of cholecystoduodenal fistulae.\u00a0Surg Laparosc Endosc.\u00a01994;4(6):433\u20135."},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Abou-Saif A and Al-Kawas FH. Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus.\u00a0Am J Gastroenterol.\u00a02002;97(2):249\u201354.","DOI":"10.1016\/s0002-9270(01)04013-8"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T23:58:10Z","timestamp":1573171090000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/82z2f1tw"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,29]]},"references-count":4,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,7,30]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2019.4.42686","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2019,5,29]]}}}