Cholecystoparietal Fistula Revealed by an Epigastric Abscess

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Abstract

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. Surgery is the best available treatment.

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Most cited references 13

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Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy.

G H Sakorafas, George Peros, S D Milingos (2007)

Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree that the vast majority of subjects should be managed by observation alone (expectant management). Selective cholecystectomy is indicated in defined subgroups of subjects, with an increased risk for the development of gallstone-related symptoms and complications. Concomitant cholecystectomy is a reasonable option for good-risk patients with asymptomatic cholelithiasis undergoing abdominal surgery for unrelated conditions. Routine cholecystectomy for all subjects with silent gallstones is a too aggressive management option, not indicated for most subjects with asymptomatic cholelithiasis. An in-depth knowledge of the natural history of gallstone disease is required to select the optimal management option for the individual subject with silent gallstones. Management options should be extensively discussed with the patient; he or she should be actively involved in the process of therapeutic decision making.

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Spontaneous cholecystocutaneous fistula presenting with an abscess containing multiple gallstones: a case report.

Süphan Ertürk, Fatih Aydogan, Ender Onur … (2005)

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. We report a case of spontaneous cholecystocutaneous fistula in a 70-year-old female patient who presented with an abscess formation in the right upper quadrant. After the incision of this infective focus, many gallstones were picked up. One-stage open cholecystectomy and excision of the fistula tract were carried out after control of the abdominal wall infection.

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Spontaneous cholecystocutaneous fistula.

Aqeel Siddiqui, Adarsh Vasanth, Kevin A. O'Donnell (2004)

Spontaneous cholecystocutaneous fistula is rarely observed today because of the early diagnosis and management made possible by ultrasonography, broad-spectrum antibiotics, and effective surgical management of biliary tract disease. We present a case of spontaneous cholecystocutaneous fistula due to cholecystitis.

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Author and article information

Journal

Journal ID (publisher-id): CRG

Journal ID (pmc): CRG

Journal ID (doi): 10.1159/issn.1662-0631

Title: Case Reports in Gastroenterology

Publisher: S. Karger AG

ISSN (Electronic): 1662-0631

Publication date Subscription-year: 2017

Publication date Collection: January – April 2017

Publication date (Electronic): 19 April 2017

Volume: 11

Issue: 1

Pages: 225-228

Affiliations

Department of Digestive Surgery, Cocody University Hospital, Abidjan, Ivory Coast

Author notes

*Assamoi Brou Fulgence Kassi, Department of Digestive Surgery, Cocody University Hospital, 06 BP 480, Abidjan 06 (Ivory Coast), E-Mail kassful3@gmail.com

Article

Publisher ID: 468513 Pmcid ID: PMC5437430 Other ID: Case Rep Gastroenterol 2017;11:225–228

DOI: 10.1159/000468513

PMC ID: PMC5437430

PubMed ID: 28559782

SO-VID: 4f490805-a0f7-4951-afbc-9de69bd670ef

License:

This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 24 January 2017

Date accepted : 27 February 2017

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Figures: 2, Pages: 4

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Cholecystoparietal Fistula Revealed by an Epigastric Abscess

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Abstract

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Karger: Gastroenterology

Most cited references 13

Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy.

Spontaneous cholecystocutaneous fistula presenting with an abscess containing multiple gallstones: a case report.

Spontaneous cholecystocutaneous fistula.

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