Spontaneous cholecystocutaneous fistula.
BACKGROUND
An external biliary fistula is a rare complication of gallstone disease. We present a case of cholecystocutaneous fistula successfully treated with excision and cholecystectomy.


METHODS
A 67-year-old man presented with a persisting discharge from what was thought to be an'abscess' in the right hypochondrium, which had previously been incised and drained.


RESULTS
Investigation with computed tomography, ultrasound scanning and sinography demonstrated a cholecystocutaneous fistula and calculous cholecystitis. The fistulous track was excised together with the gallbladder.


CONCLUSIONS
This condition is rarely seen nowadays due to the greater availability of antibiotic therapy and biliary surgery. Cholecystectomy is the preferred treatment, although in a few patients, the fistula may close spontaneously.
Flora
H S
HS
Department of General Surgery, Barts and the London NHS Trust,The Royal London Hospital, London, UK.
Bhattacharya
S
S