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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

Indian J Surg 2013 Jun 23;75(Suppl 1):188-91. Epub 2012 Jun 23.

Department of General surgery, Sri Guru Ram Das Institute of Medical Science and Research, Vallah, Amritsar, Punjab India.

Cases of spontaneous cholecystocutaneous fistula continue to attend surgical outpatient department in-spite of tremendous improvement in early diagnosis and treatment of gallbladder disease. It occurs as a complication of acute suppurative cholecystitis or neglected chronic cholecystitis due to cholelithiasis. We report two cases of spontaneous cholecystocutaneous fistula due to chronic cholecystitis with review of literature. Read More

Surg Laparosc Endosc Percutan Tech 2013 Dec;23(6):e229-31

*General Surgery Residency Program, Doctors Hospital †Department of Surgery, Grant Medical Center, Columbus, OH.

Acute cholecystitis in patients unfit for general anesthesia often initially requires cholecystectomy tube placement without cholecystectomy. The best way to definitively manage those patients with irreversible medical conditions, leaving them unable to undergo cholecystectomy, has yet to be defined. Laser lithotripsy is currently used in the management of stones of the genitourinary system. Read More

ANZ J Surg 2014 Nov 31;84(11):888-9. Epub 2013 Oct 31.

Upper Gastro-Intestinal and Hepato-Biliary Unit, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.

Indian J Gastroenterol 2014 Sep;33(5):498

Department of Surgery, Government Medical College and Hospital, Sector 32, Chandigarh, 160 047, India,

Indian J Surg 2012 Apr 16;74(2):191-3. Epub 2011 Aug 16.

King George Medical College, Lucknow, Uttar Pradesh India.

Most cholecystocutaneous fistulas are postoperative complications of liver and biliary tract surgery or trauma. External biliary fistulas rarely occur spontaneously as a result of intrahepatic abscess (pyogenic or parasitic), necrosis or perforation of the gallbladder, or other inflammatory process involving the biliary tree. A cholecystocutaneous fistula as a presentation of an underlying cancer arising from the gall bladder is an extremely uncommon finding. Read More

Bratisl Lek Listy 2012 ;113(7):445-7

Gulhane Military Medical Academy, Department of General Surgery, Istanbul, Turkey.

Spontaneous perforation of gallbladder as a complication of biliary stones may lead to a cholecystocutaneous abscess or fistula. The pathophysiology of this condition has been associated with increased pressure in the gallbladder, secondary to biliary obstruction. Ultrasonography and Computed Tomography (CT) can be used for diagnosis of cholecystocutaneous abscess or fistula. Read More

Cir Esp 2013 Jun-Jul;91(6):396-7. Epub 2012 May 7.

Ugeskr Laeger 2012 Apr;174(18):1235-6

Kirurgisk Afdeling, Regionshospitalet Horsens, Denmark.

We report a case of an 89 year-old woman, with an abscess in the right breast. On incision the abscess produced bile. Ultrasound scan, computed tomography, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography showed a fistula from a subphrenic abscess to the breast. Read More

Ann Ital Chir 2012 Jan-Feb;83(1):67-9

First Surgical Department, General Regional Hospital 'George Papanikolaou', Thessaloniki, Greece.

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 50 mg twice a day was administrated intravenously to the patient according to sensitivity results. Read More

ANZ J Surg 2011 Nov;81(11):847

Am Surg 2011 Dec;77(12):E285-6

Department of Plastic and Reconstructive Surgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan.

J Am Anim Hosp Assoc 2012 Jan-Feb;48(1):43-9. Epub 2011 Dec 21.

Department of Veterinary Clinical Sciences, Oklahoma State University Center for Veterinary Health Sciences, Stillwater, OK, USA.

The purpose of this case report was to describe the surgical correction of a cholecystocutaneous fistula in a dog. A 6 yr old Vizsla presented with a 2 mo history of a chronic draining wound on the right ventral thorax. Diagnostics revealed numerous fistulous tracts opening at a single site on the right ventrolateral chest wall, extending caudodorsally through the chest wall and diaphragm to the region of the right medial liver lobe. Read More

Arch Surg 2011 Apr;146(4):487-8

Department of Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.

BMJ Case Rep 2011 Jul 20;2011. Epub 2011 Jul 20.

Department of Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.

Case Rep Gastroenterol 2010 Sep 15;4(3):356-360. Epub 2010 Sep 15.

Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Bologna, Italy.

Spontaneous cholecystocutaneous fistula is a rare complication of chronic calculous cholecystitis because currently gallstones are diagnosed and treated at an early stage. This occurrence is possible even if it seems actually to be rare. We report the case of a 90-year-old woman admitted to our hospital with diarrhea of 4 days duration and low-grade fever (37. Read More

JBR-BTR 2010 Jul-Aug;93(4):198-200

Department of Abdominal Surgery, General Hospital, AZ. St. Maarten, Duffel, Belgium.

Spontaneous cholecystocutaneous abscesses or fistulae are rare complications of neglected biliary calculous disease which have become extremely rare during the last decades. We report a case of spontaneous cholecystocutaneous abscess in a 69-year-old male who presented with a mass in the right subcostal region.The diagnosis was made by CT scan with multiplanar reformating. Read More

Gastroenterol Hepatol 2010 Aug-Sep;33(7):553-4

Interact Cardiovasc Thorac Surg 2010 May 5;10(5):828-9. Epub 2010 Feb 5.

Department of Thoracic Surgery, Norfolk and Norwich University Hospital, NHS Trust, Norwich, NR4 7UY, UK.

We report a case of recurrent chest wall abscesses overlying a right thoracotomy scar four years after a pneumonectomy for a right middle lobe bronchus squamous cell carcinoma. Exploration of the abscess cavities revealed no intra-thoracic or intra-abdominal communication. The patient developed sinuses in his thoracotomy scar and two years later, two gallstones were expelled from these sinuses. Read More

J Surg Case Rep 2010 Jul 1;2010(5). Epub 2010 Jul 1.

Northampton General Hospital, Northampton, UK.

Spontaneous cholecystocutaneous fistula, one of the rarest complications of acute cholecystitis, has been reported in fewer than 25 cases over the past 50 years. Not only is this case rare but interestingly the patient experienced no pain or symptoms consistent with gallbladder pathology leading up to her hospitalisation. Furthermore, laboratory studies, microbiology and computed tomography scanning did not establish a diagnosis until the fistula passed calculi. Read More

J Indian Med Assoc 2007 Nov;105(11):644, 646, 656

Department of General Surgery, RG Kar Medical College and Hospital, Kolkata.

Chronic calculous cholecystitis is quite a common disease entity today. However, advances in diagnostic imaging and use of broad-spectrum antibiotics have facilitated its early detection and treatment. Hence complications of untreated calculous cholecystitis have shown a steady decline. Read More

HPB (Oxford) 2001 ;3(4):279-80

Department of General Surgery, Barts and the London NHS Trust,The Royal London Hospital, London, UK.

Background: An external biliary fistula is a rare complication of gallstone disease. We present a case of cholecystocutaneous fistula successfully treated with excision and cholecystectomy.

Case Outline: A 67-year-old man presented with a persisting discharge from what was thought to be an'abscess' in the right hypochondrium, which had previously been incised and drained. Read More

Case Rep Gastroenterol 2008 Jul 9;2(2):219-23. Epub 2008 Jul 9.

Division of Surgery and Oncology, Royal Liverpool University Hospital, Liverpool, UK.

Abdominal wall abscess secondary to spontaneous cholecystocutaneous gallstone fistulation is an uncommon presentation of a rare pathological process. Having been described relatively frequently in the 19th century, it is now much less common in the late 20th and early 21st century, probably due to earlier recognition of symptoms, better imaging and surgical treatment of biliary tract disease. Here we describe a report of a case with an unusual clinical presentation of the already rare pathological disease process of spontaneous cholecystocutaneous fistula. Read More

Case Rep Gastroenterol 2008 Mar 11;2(1):71-5. Epub 2008 Mar 11.

Department of General and Colorectal Surgery, Lister Hospital, Stevenage, UK.

Spontaneous cholecystocutaneous fistula is an exceptionally unusual complication of chronic calculous cholecystitis now. The remarkable drop in incidence is probably associated with the introduction of antimicrobial therapy and early surgical management of biliary tract disease. We report a case of spontaneous cholecystocutaneous fistula in a patient who presented with an abscess in the right upper quadrant. Read More

Ulster Med J 2007 Sep;76(3):166-7

Yeovil District Hospital, Somerset, United Kingdom.

Sao Paulo Med J 2006 Jul;124(4):234-6

Department of Surgery, Faculdade de Medicina, Universidade de Santo Amaro, São Paulo, Brazil.

Context: Spontaneous cholecystocutaneous abscess or fistula is an extremely uncommon complication secondary to cholecystitis. Over the past 50 years fewer than 20 cases of spontaneous cholecystocutaneous fistulas have been described in the medical literature. We here report a case of subcutaneous gallstone as a rare clinical presentation of the already uncommon cholecystocutaneous fistula. Read More

Med Clin (Barc) 2006 Sep;127(9):359

Mt Sinai J Med 2005 Nov;72(6):402-4

Istanbul University, Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul, Turkey.

Spontaneous cholecystocutaneous fistula is a rare complication of chronic calculous cholecystitis. This complication, a result of the natural history of gallbladder stones, was formerly common. Today it is rare, because of early diagnosis and treatment of biliary tract diseases. Read More

J Coll Physicians Surg Pak 2005 Nov;15(11):726-7

Department of General Surgery, Al-Noor Specialist Hospital, Macca, Kingdom of Saudi Arabia.

We report a case of cholecystocutaneous fistula in a 90 years old female as a complication of gallstone disease. Patient presented with necrotizing fasciitis of anterior abdominal wall and cholecystocutaneous fistula. She was bedridden for the last 3 years due to cerebral vascular accident. Read More