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Spontaneous cholecystocutaneous fistula
1Department of General Surgery, Barts and the London NHS Trust,The Royal London Hospital, London, UK.
Background:
An external biliary fistula is a rare complication of gallstone disease. We present a case of cholecystocutaneous fistula successfully treated with excision and cholecystectomy.
Case Outline:
A 67-year-old man presented with a persisting discharge from what was thought to be an'abscess' in the right hypochondrium, which had previously been incised and drained.
Results:
Investigation with computed tomography, ultrasound scanning and sinography demonstrated a cholecystocutaneous fistula and calculous cholecystitis. The fistulous track was excised together with the gallbladder.
Discussion:
This condition is rarely seen nowadays due to the greater availability of antibiotic therapy and biliary surgery. Cholecystectomy is the preferred treatment, although in a few patients, the fistula may close spontaneously.
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