Abstract
A thirty-year-old woman was transferred to the United Kingdom two weeks after bowel resection for superior mesenteric vein thrombosis. She was dehydrated, malnourished and complained of abdominal pain. Computerized Tomography revealed no intra abdominal collection and she was managed conservatively. She settled without intervention and was sent home after 30 days. Fourteen days later (fifty-nine days since her initial operation), she represented with abdominal pain and discharge from two small wound sinuses on the anterior abdominal wall. A sinogram was performed and contrast was seen to pass into the common bile duct, the cystic duct and into the duodenum. A cholecysto-cutaneous fistula was demonstrated. She underwent an ERCP and biliary stenting. The discharge settled and her abdominal pain resolved. Spontaneous cholecysto-cutaneous fistulae are rare due to the early diagnosis and treatment of biliary tract disease. This case is particularly unusual as the patient had no evidence of biliary tract disease and the cause of the fistula still remains unclear.
Published Version
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