Spontaneous cholecystocutaneous fistula draining from an abdominal scar from previous surgical drainage

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Orestis Ioannidis
George Paraskevas
Anastasios Kotronis
Stavros Chatzopoulos
Athina Konstantara
Nikolaos Papadimitriou

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.

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How to Cite
Orestis Ioannidis, et al. “Spontaneous Cholecystocutaneous Fistula Draining from an Abdominal Scar from Previous Surgical Drainage”. Annali Italiani Di Chirurgia, vol. 83, no. 1, Jan. 2012, pp. 67-70, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2320.
Section
Case Report