A woman in her mid-30s presented with upper right quadrant abdominal pain. On examination, there was mild upper right quadrant tenderness and negative Murphy's sign. Basic laboratory investigations revealed normal results except for elevated alkaline phosphatase. Subsequent imaging revealed chronic calculous cholecystitis and the dilated common bile duct harbouring stones, with pneumobilia. The patient underwent open cholecystectomy with common bile duct exploration. Intraoperatively, the gallbladder was found contracted, and densely adherent to and fistulising with the common bile duct and stomach.
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