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J Gastrointest Surg 2022 Feb 15. Epub 2022 Feb 15.

Center for Radiology and Magnetic Resonance Imaging, Clinical Center of Serbia, Pasterova 2, 11000, Belgrade, Serbia.

Surgery 2022 05 14;171(5):e17-e18. Epub 2021 Sep 14.

Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. Electronic address:

ANZ J Surg 2022 03 29;92(3):588-589. Epub 2021 Jul 29.

Colorectal Surgery, The Tweed Hospital, Tweed Heads, New South Wales, Australia.

BMJ Case Rep 2021 Feb 5;14(2). Epub 2021 Feb 5.

General Surgery, Weston General Hospital, Weston-super-Mare, North Somerset, UK.

We describe the case of a 78-year-old woman who presented to the emergency department with a 2-week history of a superficially developing mass in the lower right abdominal wall, fluctuant and non-tender with overlaying erythematous skin changes. Though resembling an abdominal wall abscess and initially listed for a simple incision and drainage, diagnostic uncertainty encouraged further investigation. CT and ultrasound confirmed the mass appeared to be in continuity with the gallbladder fossa, with the lumen also containing small bowel medially. Read More

BMJ Case Rep 2020 Dec 15;13(12). Epub 2020 Dec 15.

Department of Gastroenterology and Hepatology, Faculty of Medicine and University Hospital Cologne, Cologne, North Rhine Westphalia, Germany.

A 78-year-old man presented to the hospital with acute right upper quadrant pain, fever and nausea. A focused abdominal ultrasound and abdominal CT scan were performed demonstrating an acute calculous cholecystitis with gallbladder perforation. Although a CT-guided cholecystostomy was performed and a pericholecystic abscess was relieved promptly, the patient developed a cholecystocutaneous fistula in the right hypochondriac region. Read More

Ann Med Surg (Lond) 2020 Nov 2;59:180-185. Epub 2020 Oct 2.

Department of Surgery, Aleppo University Hospital, Syria.

Cholecystocutaneous Fistula (CCF) is a type of external biliary fistula, which connects the gallbladder with the skin. Thilesus first described this phenomenon in 1670. There is usually a history of calculi in the gallbladder or neglected gallbladder disease. Read More

Pol Przegl Chir 2019 Dec;92(5):1-5

Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, India.

Introduction: Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease with imaging and appropriate and prompt antibiotic and surgical treatment.

Case Report: We report our experience with a 40-year-old woman who presented with a yellowish discharge from the umbilicus. Abdominal examination revealed a sinus opening at the umbilicus with the yellowish discharge and a vague mass in the right hypochondrium. Read More

BMJ Case Rep 2020 Sep 2;13(9). Epub 2020 Sep 2.

General Surgery, EKHUFT, Ashford, UK.

A 79-year-old man developed a spontaneous cholecystocutaneous fistula 12 months after an initial episode of acute cholecystitis. A laparoscopic cholecystectomy procedure was twice abandoned due to extensive adhesions and active disease, limiting safe dissection of Calot's triangle. Abdominal collections formed and a spontaneous cholecystocutaneous fistula developed. Read More

Int J Surg Case Rep 2020 23;67:42-44. Epub 2020 Jan 23.

Surgery Department, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria.

Introduction: Cholecystocutaneous fistula is an extremely rare complication of gallstones. The majority of the fistulae localize into the right upper quadrant of the abdomen. Diagnosis is not easy because the symptoms are nonspecific. Read More

Cureus 2019 Apr 12;11(4):e4444. Epub 2019 Apr 12.

Family Medicine, United Hosptial Center, Bridgeport, USA.

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. Read More

Rev Esp Enferm Dig 2019 05;111(5):407-408

Medicina Interna, Hospital San Agustín, España.

Spontaneous external biliary fistula or cholecystocutaneous fistula is defined as the rupture of the gallbladder through all layers of the abdominal wall, with development of a fistulous tract to the skin without prior biliary surgery or trauma. We report the case of an octogenarian woman with debilitating comorbidities and consequently immunosuppression who presented with spontaneous external biliary fistula and a history of ERCP three months before, a procedure that was carried out with no apparent immediate complications. Read More

BMJ Case Rep 2019 Feb 13;12(2). Epub 2019 Feb 13.

Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.

A 70-year-old woman was referred to our hospital from primary health centre with complaints of pain in the abdomen, swelling and discharging sinus in the right hypochondrium since 2 years. She had received anti-tubercular treatment for 18 months as the wedge biopsy of the sinus tract suggested granulomatous lesion. As the symptoms did not subside she was referred to our hospital. Read More

Ned Tijdschr Geneeskd 2018 Jun 22;162. Epub 2018 Jun 22.

Ikazia Ziekenhuis, afd. Heelkunde, Rotterdam.

A 75-year-old man developed a cholecystocutaneous fistula after conservative treatment for cholecystitis. Six months later, clinical and radiological examination revealed an abscess at the site of the fistula. Upon incision there was minimal pus, but a large gallstone was extracted. Read More

J Gastroenterol Hepatol 2019 Jan 12;34(1):11. Epub 2018 Jun 12.

Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

F1000Res 2017 27;6:1768. Epub 2017 Sep 27.

Department of Surgery, Policlinico Vittorio Emanuele University Hospital, University of Catania, Catania, Sicily, 95100, Italy.

One of the most unusual complications in cholethiasis is spontaneous cholecystocutaneous fistula, which has only been reported a few times in the literature.  We report the case of a 76 year old man who presented with a right hypochondrium subcutaneous abscess, with pain evoked through palpation.  No comorbidity in the patient's medical history were noted. Read More

Clin J Gastroenterol 2018 Feb 31;11(1):83-86. Epub 2017 Oct 31.

Department of Surgery, Bellland General Hospital, 500-3 Higashiyama, Naka-ku, Sakai, Osaka, 599-8247, Japan.

A spontaneous external biliary fistula is most commonly a cholecystocutaneous fistula secondary to acute cholecystitis. A fistula arising from an intrahepatic duct is extremely rare. An 87-year-old man presented with swelling of the epigastric region and right upper quadrant abdomen. Read More

ACG Case Rep J 2017 30;4:e102. Epub 2017 Aug 30.

Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England.

Rom J Morphol Embryol 2017 ;58(2):575-583

IInd Surgical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania;

Spontaneous cholecystocutaneous fistula (SCF) is a rare complication of neglected calculous biliary disease and also an extremely rare complication of gallbladder neoplasm. This pathology has become even rarer because of prompt diagnosis and expedient surgical intervention for gallstones. So far, there is one published report of a SCF due to gallbladder adenocarcinoma. Read More

Case Rep Gastroenterol 2017 Jan-Apr;11(1):225-228. Epub 2017 Apr 19.

Department of Digestive Surgery, Cocody University Hospital, Abidjan, Ivory Coast.

Cholecystocutaneous fistula, the ultimate complication of abscessed or overlooked acute cholecystitis, is due to perforation of the gallbladder in the abdominal wall. The authors report an unusual case of cholecystoparietal fistula revealed by an epigastric abscess. Fistulography and modern imaging tools make the diagnosis easier. Read More

Ann R Coll Surg Engl 2017 Mar 10;99(3):e1-e2. Epub 2017 Jan 10.

Gastrointestinal Surgery, National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals and University of Nottingham, Queen's Medical Centre , Nottingham , UK.

There have been reports of late discharge of gallstones through operative wounds after spillage into the peritoneal cavity during laparoscopic cholecystectomy and after the development of spontaneous cholecystocutaneous fistulae. However, spontaneous discharge of gallstones from the tract of a percutaneous cholecystostomy or percutaneous drainage of a perforated gall bladder has not, to the best of our knowledge, been reported previously. We report a case in which a patient who had a percutaneous drain inserted for a perforated gall bladder discharged 34 gallstones from the tract after removal of the 7-F pigtail catheter. Read More

Ann Med Surg (Lond) 2016 Dec 25;12:106-108. Epub 2016 Nov 25.

Department of General Surgery, Ar Rayan Hospital, Dr Sulaiman Al Habib Medical Group, PO Box 100266, Riyadh, Saudi Arabia.

Introduction: Spontaneous cholecystocutaneous abscess is an extremely uncommon complication of acute suppurative cholecystitis. Over the past century very few cases of spontaneous cholecystocutaneous fistulas have been described in the medical literature. We, here, report a case of abdominal wall abscess secondary to cholecystocutaneous fistula. Read More

Ann R Coll Surg Engl 2017 Jan 23;99(1):e15-e18. Epub 2016 Aug 23.

Lister Hospital , UK.

INTRODUCTION Cholecystectomy is one of the most common elective procedures carried out by general surgeons. Most patients present with typical biliary anatomy and simple gallstone disease. Intraoperative and postoperative courses are frequently predictable and uncomplicated. Read More

BMJ Case Rep 2016 Mar 31;2016. Epub 2016 Mar 31.

Kingston Hospital, Kingston Upon Thames, UK.

A 68-year-old woman presented to the emergency department, with an abscess in the right upper anterior abdominal wall. She had a medical history of an open cholecystectomy 20 years prior, diabetes, obesity and a laparotomy for perforated sigmoid diverticular disease complicated by a large parastomal hernia. CT revealed this subcutaneous abscess to track intra-abdominally through the liver and communicate with the gallbladder fossa. Read More

Int J Surg Case Rep 2016 27;18:42-4. Epub 2015 Nov 27.

Tunbridge Wells Hospital, Tonbridge Road, Tunbridge Wells, Kent TN2 4QJ ,UK.

Introduction: Gall bladder perforation is associated with high mortality rates and therefore must be recognised and managed promptly. We present an unusual presentation of spontaneous gall bladder perforation.

Case Presentation: An elderly lady with multiple medical co-morbidities was admitted with sepsis following a fall. Read More

Cir Cir 2015 Jan-Feb;83(1):61-4

Servicio de Medicina General, Departamento de Cirugía, Hospital Civil de Ciudad Madero, Ciudad Madero, Tamaulipas, México.

Background: Spontaneous cholecystocutaneous fistula is defined as a gallbladder communication with the external environment through the abdominal wall rupture; the first reports were written in the seventeenth century by Thilesus. During the past 50 years 25 cases have been reported.

Clinical Case: We report a case of a 30-year-old woman presented with a five-year history of biliary colic, six months prior to medical assessment presents outlet of biliary material and gallstones spontaneously in the right upper quadrant. Read More

Can Vet J 2014 Dec;55(12):1163-6

Department of Veterinary Medical Science (Fabbi, Volta, Quintavalla, Zubin, Manfredi, Martini, Gnudi) and Department of Physics and Earth Sciences "M. Melloni" (Mantovani, Tribaudino), University of Parma, via del Taglio 10, 43100 Parma, Italy.

A 7-year-old dog was presented with a history of an open lesion on the right thoracic wall, discharging honey-like fluid and small stones. Ultrasonography and computed tomographic fistulography identified a cholecystocutaneous fistula; cholecystectomy was curative. Veterinarians should consider this disease in patients with long-term discharging lesions on the right thoracic or abdominal wall. Read More

Rev Med Chil 2014 Aug;142(8):1076-7

BMJ Case Rep 2014 May 26;2014. Epub 2014 May 26.

Sunderland Royal Hospital, Sunderland, UK.

This case describes a 94-year-old woman who presented 2 years postsutured para-umbilical hernia repair with a painful black lump protruding through her scar with blood stained discharge. This was initially thought to be either ischaemic bowel secondary to strangulated incisional hernia or a large organised haematoma. An urgent CT scan was performed following which the patient passed two large calculi and bile-stained fluid spontaneously through the wound, making the diagnosis somewhat clearer. Read More

Case Rep Gastroenterol 2014 Jan 3;8(1):119-22. Epub 2014 Apr 3.

Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ont., Canada ; Department of Surgery, Windsor Regional Hospital - Metropolitan Campus, Windsor, Ont., Canada.

Cases of cholecystocutaneous fistulas are now a rare occurrence as a result of rapid diagnosis and treatment. We present a case of cholecystocutaneous fistula developing after the removal of a percutaneous drain for the treatment of acute cholecystitis. Re-occurring infection and presence of gallstones led to fistulization of the gallbladder fundus and the development of a tract along the path created by the drain. Read More