MS-1448

A 59-year-old male arrives at the emergency department complaining of severe abdominal pain, vomiting, and swelling in the central abdomen.

During his last visit to his family doctor two weeks ago, he experienced colicky abdominal pain and was diagnosed with gallstones after further testing. He was scheduled for an elective cholecystectomy in 8 weeks.

The patient is administered pain relief and scheduled for an urgent abdominal X-ray (AXR).

What is the most probable finding on the AXR that indicates a cholecystoenteric fistula?