Spontaneous cholecystocutaneous fistula: an uncommon complication of acute cholecystitis

• Published in: BMJ case reports Vol. 13; no. 12; p. e238063
• Main Authors: Kasper, Philipp, Kaminiorz, Julia, Schramm, Christoph, Goeser, Tobias
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 15-12-2020; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Abdomen; Abscesses; Aged; Antibiotics; Bile; Biliary Fistula - diagnostic imaging; Biliary Fistula - etiology; Biliary Fistula - therapy; Case Report; Case reports; Cellulitis; Cholecystectomy; Cholecystitis, Acute - complications; Cholecystitis, Acute - surgery; Cutaneous Fistula - diagnostic imaging; Cutaneous Fistula - etiology; Cutaneous Fistula - therapy; Drainage; Fever; Fistula; Gallbladder; Gallbladder - diagnostic imaging; Gallbladder - surgery; Gallbladder diseases; Gallstones; gastroenterology; gastrointestinal surgery; Humans; Male; Medical imaging; Patients; surgery; Tomography, X-Ray Computed - methods; Ultrasonic imaging; ultrasonography; Ultrasonography - methods; gastroenterology; gastrointestinal surgery; ultrasonography; surgery
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-238063

A 78-year-old man presented to the hospital with acute right upper quadrant pain, fever and nausea. A focused abdominal ultrasound and abdominal CT scan were performed demonstrating an acute calculous cholecystitis with gallbladder perforation. Although a CT-guided cholecystostomy was performed and a pericholecystic abscess was relieved promptly, the patient developed a cholecystocutaneous fistula in the right hypochondriac region. A cholecystocutaneous fistula is an extremely rare complication that may occur in patients with acute calculous or acalculous cholecystitis, chronic gallstone disease, gallbladder carcinoma or prior hepatobiliary surgery.