Spontaneous Cholecystocutaneous Fistula of Anterior Abdominal Wall with Subcutaneous Gallstones: About a Rare Case and Review of the Literature

Khalid El Haoudi,Pierlesky Elion Ossibi,Salima Rezzouk,Khalid Mazaz,Mourad Oussaid,Said Ait Laalim,Imane Toughrai,Karim Ibn Majdoub Hassani

doi:10.4236/ss.2014.52010

Abstract

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 a case of spontaneous cholecystocutaneous fistula of Anterior Abdominal Wall with subcutaneous gallstones admitted in the medical oncology unit of HASSAN II University Hospital. An 64-year-old woman, presented with a large subcutaneous abscess in the right subcostal area with swelling. An abdominal computed tomography scan showed a subcutaneous gallstone and communication between the abscess and the gallbladder. Cholecystectomy was performed and the abdominal wall abscess was drained externally. This case report demonstrates that maintaining a high degree of suspicion of this rare entity is helpful in achieving correct preoperative diagnosis, and that computed tomography scan should be performed in all cases of unexplained abdominal wall suppuration.

Highlights

Spontaneous cholecystocutaneous fistula is a rare complication of gallbladder empyema without treatment
We present a new case with anterior abdominal wall abscess secondary to subcutaneous gallstones and we analyze different data about diagnosis, possible etiology and treatment of this entity
We present a case of a 64-year-old woman, drained twice for an abdominal wall abscess, presenting to the emergency department with a swelling on the anterior abdominal wall in the right upper quadrant

Summary

Introduction

Spontaneous cholecystocutaneous fistula is a rare complication of gallbladder empyema without treatment. The incidence has further decreased with the advent of ressucitation and surgical treatment. Traditional treatment consists of broad-spectrum antibiotics administration, cholecystectomy and fistula drainage. We present a new case with anterior abdominal wall abscess secondary to subcutaneous gallstones and we analyze different data about diagnosis, possible etiology and treatment of this entity

Case Presentation

Discussion