Spontaneous Cholecystocutaneous Fistula in a Dog

Abstract

The purpose of this case report was to describe the surgical correction of a cholecystocutaneous fistula in a dog. A 6 yr old Vizsla presented with a 2 mo history of a chronic draining wound on the right ventral thorax. Diagnostics revealed numerous fistulous tracts opening at a single site on the right ventrolateral chest wall, extending caudodorsally through the chest wall and diaphragm to the region of the right medial liver lobe. Exploratory laparotomy revealed the apex of the gallbladder adhered to the diaphragm with a tract of fibrous tissue extending along the diaphragm laterally to the right thoracic wall. Cholecystectomy was performed. The fistulous tract was incised to expose the lumen of the fistula, and the fistula was omentalized. Twenty-eight months after surgery, the dog had had no recurrence of the fistulous tract. Exploratory laparotomy allowed excellent visualization of the intra-abdominal path of the fistula and facilitated the ease of resection of the source. Cholecystectomy resulted in rapid and complete resolution of the fistula without the need for excision of the fistula. Although rare, gallbladder disease should be a differential for chronic fistulous tracts.

Cholecystocutaneous fistula and associated cholelithiasis in an eight‐year‐old dachshund

“…In previous reports, E scherichia coli 4 6 and Enteroococcus subspecies4 have been isolated, and Pasteurella subspecies was cultured in this patient. Culture and sensitivity is considered important to prescribe appropriate antibiotic therapy.…”

“…Spontaneous cholecystocutaneous fistula is a rare condition in dogs, with only three cases previously reported in the veterinary literature,4–6 and cholelithiasis was only a feature in one of these 6…”

“…The presentation of cholecystocutaneous fistulae is similar in humans and dogs and involves a painless draining sinus tract in the right lateral abdominal or thoracic region, overlying the costal cartilages 3–5 11. Other reported exit sites for cholecystocutaneous fistulae in humans include the left hypocondrium, umbilicus, right lumbar region, left‐side costal margin, gluteal region, right iliac fossa, right groin or back 2 3 9 12.…”

“…In humans, if a honey‐like discharge is present, cholecystocutaneous fistula is normally included in the list of potential diagnoses with a high index of suspicion 4…”

“…To the authors’ knowledge, only three reports of spontaneous cholecystocutaneous fistulae have been described in the veterinary literature,4 5 and only one was associated with cholecystolithiasis 6. A case of an umbilicobiliary fistula (considered to be a congenital condition) has also been reported in a dog 7.…”