Spontaneous Cholecystocutaneous Fistula

Abstract

ABSTRACT Spontaneous biliary fistulae are encountered, not very rarely, in one's surgical practice. These fistulae are of three types: Internal, external, and combined. Internal spontaneous biliary fistulae are the commonest. External fistulae could be spontaneous or because of therapeutic, iatrogenic, or traumatic reasons are extremely rare. Spontaneous cholecystocutaneous fistula (SCCF), secondary to calculous cholecystitis, is an extremely rare presentation in the present-day scenario. It used to be quite common before the year 1900, but is very rare now because of better management of cholecystitis and cholelithiasis. Usually, SCCF is a complication of neglected chronic cholelithiasis. This is seldom seen today because of the early diagnosis and better management made feasible by ultrasound as first-line investigation, broad spectrum antibiotics, and effective surgical management of biliary tract diseases. It is a very rare case of 35-year-old female patient presenting in the outpatient department, with the multiple stones carefully preserved, which she had been extruding through the fistulous opening in the umbilicus, for the last 1 year. She was investigated and was operated for the same condition. Though the entity is very rare, clinicians should keep this condition in mind while examining any case of chronic discharging sinus or fistula on the abdominal wall, particularly the wound extruding stones in which case the diagnosis is selfrevealing. In the absence of positive history of expelling stones, the diagnosis can be confirmed by computerized tomogram fistulography. Though the early diagnosis and improvement in the management of gallbladder disease has improved tremendously, the possibility of this condition arising mostly from the neglected gallbladder disease should always be kept in mind as such cases are again being reported from all over the world. How to cite this article Abbey R. Spontaneous Cholecystocutaneous Fistula. Int J Adv Integ Med Sci 2016; 1(4):196-198.