1 Jan 2012Case Report
Spontaneous cholecystocutaneous fistula draining from an abdominal scar from previous surgical drainage
Orestis Ioannidis 1George Paraskevas 2Anastasios Kotronis 1Stavros Chatzopoulos 1Athina Konstantara 1Nikolaos Papadimitriou 1
Affiliations
Article Info
1 First Surgical Department, General Regional Hospital ‘George Papanikolaou’. Thessaloniki, Greece
2 Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece
Ann. Ital. Chir., 2012, 83(1), 67-70;
Published: 1 Jan 2012
Copyright © 2012 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
We present a rare case of cholecystocutaneous fistula draining from an old surgical scar in the right upper abdominal quadrant following chronic calculous cholecystitis. A 71 year old male presented to the emergency department with a persistent bilious drainage from an old surgical scare, from surgical drainage, of the right upper abdominal quadrant for about a week. Cultures from the draining fluid grew Staphylococcus hominis, Escherichia coli and Klebsilla pneumoniae and tigecycline 50mg twice a day was administrated intravenously to the patient according to sensitivity results. An abdominal US revealed the presence the gallbladder with calculi in a superficial position and the fistulogram revealed a cholecystocytaneous fistula arising from the fundus of the gallbladder. At laparotomy a fistula track was found connecting the gallbladder fundus to the skin, which was dissected and a cholecystectomy was performed. Spontaneous cholecystocutaneous fistula is rarely observed today, mostly as a complication of chronic calculous cholecystitis. Most often it arises from the gallbladder fundus and the clinical presentation is that of a painless draining sinus tract in the right upper quadrant Diagnosis is aided by abdominal CT scan and ultrasound and treatment is with elective cholecystectomy and excision of the fistula.
Keywords
- Cholecystitis
- Fistula
- Gallbladder
- Liver