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Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Cholecystocutaneous Fistula.

Francisco Tustumi1,2, Giane Prata da Costa Filha1, Guilherme Carvalhal Gnipper Cirillo1

  • 1Department of Health Sciences, Hospital Israelita Albert Einstein, Sao Paulo 05652-900, Brazil.

Diagnostics (Basel, Switzerland)
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A delayed diagnosis of gallbladder disease in a remote area led to a skin fistula. This case highlights healthcare access challenges and the need for timely medical intervention.

Keywords:
fistulagallbladderhealth inequitieshealthcare disparities

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Area of Science:

  • Medical Imaging
  • Gastroenterology
  • Public Health

Background:

  • Delayed diagnosis of abdominal pain is common in underserved rural areas.
  • Inadequate initial management can lead to severe complications.
  • Gallbladder disease presents diagnostic challenges in resource-limited settings.

Purpose of the Study:

  • To present a case of a complex gallbladder pathology.
  • To illustrate the consequences of delayed diagnosis and treatment.
  • To emphasize healthcare disparities in rural regions.

Main Methods:

  • Case report of an 88-year-old indigenous woman.
  • Review of patient history including multiple hospital visits.
  • Magnetic resonance imaging (MRI) for diagnosis.

Main Results:

  • A displaced gallbladder with thickened walls and multiple stones was identified.
  • A fistulous tract extending from the gallbladder to the skin was discovered.
  • The patient experienced prolonged abdominal pain due to delayed diagnosis.

Conclusions:

  • Limited healthcare access significantly impacts patient outcomes.
  • Timely and accurate diagnosis is crucial for managing gallbladder disease.
  • This case highlights the need for improved diagnostic capabilities in rural healthcare.