Open AccessUnusual fistula demonstrating the need for an early cholecystectomy
Author(s) -
Gregory Harrison,
Roland Fernandes
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235795
Subject(s) - medicine , fistula , cholecystectomy , general surgery , laparoscopic cholecystectomy , acute cholecystitis , surgery , dissection (medical) , limiting , chronic cholecystitis , cholecystitis , fundus (uterus) , gallbladder , mechanical engineering , engineering
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.