Spontaneous cholecystocutaneous fistula secondary to xanthogranulomatous cholecystitis: a case report

J Med Case Rep. 2022 Dec 15;16(1):465. doi: 10.1186/s13256-022-03689-w.

Abstract

Background: Xanthogranulomatous cholecystitis, a rare variant of cholecystitis, may infrequently be complicated by spontaneous cholecystocutaneous fistula.

Case presentation: We report the case of a 75-year-old Saudi Arabian man who presented with "a painful area of redness" (cellulitis) over his right upper abdomen. Abdominal computed tomography revealed multiple collections, which were drained surgically. A discharging sinus was identified, and a fistulogram revealed cholecystocutaneous fistula during his follow-up visit. The patient underwent laparoscopic management and recovered uneventfully. Final histopathological evaluation confirmed acute-on-chronic xanthogranulomatous cholecystitis .

Conclusions: Although rare, surgeons should consider cholecystocutaneous fistula in the differential diagnosis of anterior abdominal wall abscesses, particularly in patients with concurrent or background symptoms of gallbladder disease. We report the first case of laparoscopic management for cholecystocutaneous fistula in Saudi Arabia.

Keywords: Case report; Cholecystocutaneous fistula; Laparoscopy; Xanthogranulomatous cholecystitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biliary Fistula* / complications
  • Biliary Fistula* / diagnostic imaging
  • Cholecystitis* / complications
  • Cholecystitis* / diagnosis
  • Cholecystitis* / surgery
  • Cutaneous Fistula* / diagnostic imaging
  • Cutaneous Fistula* / etiology
  • Cutaneous Fistula* / surgery
  • Humans
  • Male
  • Saudi Arabia

Supplementary concepts

  • Xanthogranulomatous cholecystitis