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Unusual presentation of more common disease/injury
Case report
Unusual fistula demonstrating the need for an early cholecystectomy
  1. Gregory Harrison and
  2. Roland Fernandes
  1. General Surgery, EKHUFT, Ashford, UK
  1. Correspondence to Dr Gregory Harrison; gregory.harrison1{at}nhs.net

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.

  • gastrointestinal surgery
  • general surgery

https://doi.org/10.1136/bcr-2020-235795

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    Footnotes

    • Contributors Final operation performed and followed up by RF (consultant upper gastrointestinal surgeon), case report suggested and supervised by him, case report written by GH, foundation year 1.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.