Abstract
A cholecystocolonic fistula (CCF) is a rare cause of chronic diarrhoea. It most often occurs in elderly women as a result of chronic inflammation due to gallstone disease or, rarely, malignancy. Curative treatment consists of cholecystectomy with excision of the fistula tract, but it is often overlooked preoperatively and thus entails a higher risk of postoperative complications. Here, we present a case of a 78-year-old woman with chronic diarrhoea who was diagnosed with a CCF during a colonoscopy. Cholecystectomy was complicated by acute cholangitis due to an obstructive stone in the common bile duct (CBD) that was masked preoperatively due to alternative biliary drainage via the CCF. Recognition of this rare entity can enhance clinicians' diagnostic appraisal and limit postoperative complications.