Unusual fistula demonstrating the need for an early cholecystectomy

BMJ Case Rep. 2020 Sep 2;13(9):e235795. doi: 10.1136/bcr-2020-235795.

Abstract

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. Imaging revealed an 11 cm calculus and erosion of the fundus of the gall bladder through the sheath. Definitive management was achieved with a laparoscopic assisted open cholecystectomy.

Keywords: gastrointestinal surgery; general surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biliary Fistula / etiology
  • Biliary Fistula / surgery*
  • Cholecystectomy, Laparoscopic / methods*
  • Cholecystitis, Acute / etiology
  • Cholecystitis, Acute / surgery*
  • Cholecystolithiasis / complications
  • Cholecystolithiasis / surgery*
  • Conversion to Open Surgery*
  • Cutaneous Fistula / etiology
  • Cutaneous Fistula / surgery*
  • Gallbladder / diagnostic imaging
  • Gallbladder / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Time Factors
  • Time-to-Treatment
  • Tomography, X-Ray Computed
  • Treatment Outcome