Abstract
An 87-year-old man presented acutely to our institution with a clinical diagnosis of large bowel obstruction following treatment by his general practitioner for diarrhoea. His background was of conservative treatment of cholecystitis 3 years previously. A CT scan suggested a large bowel obstruction at the level of the sigmoid colon with an intraluminal opacity identified at that point. Air was present within the biliary system and a connection could be observed between the gallbladder and the hepatic flexure. A diagnosis of a cholecystocolonic fistula was made.