The Cholecystocutaneous Fistula: A Rare Manifestation of Neglected Cholecystitis

Abstract

Introduction: Cholecystocutaneous fistula is a rare complication of acute or chronic cholecystitis, most often seen in the elderly in whom diagnosis is delayed. Management can be difficult due to it's late presentation, patient comorbidities, and poor candidacy for a major surgical intervention. We report the management of a case of cholecystocutaneous fistula in a patient with chronic lymphocytic leukemia who presented in acute sepsis. Case Report: An 89-year-old female presented with several days of abdominal pain, fever, and a right upper quadrant abdominal wall abscess with surrounding cellulitis. A CT demonstrated fistulization of the gallbladder to the anterior abdominal wall. The patient was stabilized in our ICU and external drainage of the abscess and decompression of the gallbladder was performed for source control. Physicians should be aware of the cholecystocutaneous fistula as a late complication of undiagnosed cholecystitis in the elderly patient population as well as the surgical options available for treatment.