LIVER, DUODENUM - cholecysto-duodenal fistula

This shows the undersurface of the liver to which the duodenum is adherent. The opened common bile duct can be seen and above this there is an arrow marking a fistula between the gall bladder and the duodenum.
This patient presented at the age of 87 with acute colicky abdominal pain and vomiting. At operation a volvulus of the small intestine was found together with obstruction of the small intestine by a gall bladder. At autopsy several days later, the fistula was demonstrated between a fibrotic gall bladder (not well seen in the specimen) and the duodenum. The orifice in the duodenum was approximately 1.5 cm in diameter.