Consequences of gallbladder inflammation: spontaneous cholecystocutaneous fistula: a case report

Sulakshane, Swati; Thakare, Vaibhav; Dumbre, Ramesh

doi:10.18203/2349-2902.isj20181623

Cited by 1 publication

(3 citation statements)

References 12 publications

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“…Biliary fistulas can further be broken down into external or internal categories, with the majority occurring internally. Internal connections include the duodenum, colon, stomach, jejunum, and common bile duct [2-3,6,10,12-15]. The CCF seen in this case, is a type of an EBF, which appears secondary to percutaneous drain placement with associated chronic cholecystitis.…”

Section: Discussionmentioning

confidence: 91%

“…Historically, biliary fistulas were a common outcome of longstanding gallbladder inflammation and disease [3-5]. With improving diagnostic technology and treatment, biliary fistulas are being reported to a lesser extent in the literature [6]. External biliary fistulas (EBFs), which generally connect the gallbladder to the skin, subcutaneous tissues, and abdominal wall, are increasingly rare in occurrences.…”

Section: Introductionmentioning

confidence: 99%

“…From 1890 to 1949, only 37 cases were found in the medical literature. Since 2007, only 28 cases have been published [5-6]. These fistulas can be secondary to abdominal procedures or other traumatic causes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Abdominal Wall Abscess Secondary to Cholecystocutaneous Fistula via Percutaneous Cholecystostomy Tract

Lofgren

Vasani

Singzon

2019

Cureus

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Cholecystocutaneous fistulas (CCFs) are an increasingly rare consequence of chronic gallbladder inflammation and disease. Historically, they were commonly noted in the literature by Courvoisier, Naunyn, and Bonnet in the late 1800s. Due to improvements in diagnostic imaging and treatment options in the last century, there has been a marked decrease in the incidence of the CCF cases in the literature. From the late 1890s to 1949, there were only 37 cases presented in the literature; only 28 cases have been reported since 2007. This case is only the second noted CCF in the literature that followed percutaneous cholecystostomy drain placement and removal. General surgery was consulted on a 60-year-old morbidly obese female, who presented to the emergency department after one week of fever, right upper quadrant (RUQ) pain, nausea, emesis, and shortness of breath. She had a history of acute cholecystitis treated with a cholecystostomy tube the year prior, but after the removal of the tube, she was lost to follow up. She was found to have a 14cm x 5cm fluctuant abdominal wall abscess in her RUQ that was treated with incision and drainage (I&D) along with ertapenem. She continued to improve until day 7 post-I&D when yellowish-green discharge was noted draining from the wound. After a negative hepatobiliary iminodiacetic acid scan, a follow-up abdominal computed tomography (CT) showed a contracted gallbladder with fistula formation underlying the abscess location, near the site of her prior cholecystostomy tube. A robotic-assisted cholecystectomy was performed, which improved the wound drainage, and the patient was discharged home 5 days later. This case is the only noted CCF presenting as a RUQ abscess after cholecystostomy drain placement. The patient lacks follow up after the removal of her percutaneous drain and continued inflammation in the gallbladder provided perfect nidus for the fistula formation. As seen in other CCF patients, cholecystectomy is the treatment of choice, and this case was successfully treated via robotic-assisted cholecystectomy with adhesiolysis.

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