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Indian Journal of Gastroenterology

, Volume 33, Issue 5, pp 498–498 | Cite as

Spontaneous cholecystocutaneous abscess

  • Mayank JayantEmail author
  • Robin Kaushik
  • Ashok K. Attri
IMAGE

Keywords

Public Health Abdominal Pain Early Diagnosis Abdominal Wall Nineteenth Century 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Spontaneous cholecystocutaneous abscess or fistula is an uncommon complication of acute cholecystitis. This entity, frequent in the nineteenth century, is now rare with only 20 reported cases in the last 50 years [1]. This 42-year-old female presented with upper abdominal pain, fever, chills, swelling, and discharge in upper abdomen. Examination revealed a ruptured abscess cavity in the right hypochondrium (Fig. 1). Ultrasonography showed inflamed gallbladder, with multiple stones, adherent to abdominal wall. The cholecystocutaneous abscess was drained (Fig. 2), antibiotics were started, and open cholecystectomy was done 5 days later. The condition is invariably a complication of neglected calculus disease [2]. Obstruction of cystic duct neck due to stone leads to inflammation, adherence of gallbladder to abdominal wall, parietal abscess, and eventually a fistula. Single-stage management in the form of cholecystectomy and debridement/drainage of abscess cavity along with antibiotic cover is the preferred approach. The declining incidence is likely due to early diagnosis, use of antibiotics, and prompt cholecystectomy [2].
Fig. 1

Ruptured abscess cavity in the right hypochondrium

Fig. 2

Drained cholecystocutaneous abscess

References

  1. 1.
    Junior RJ, Nahas J, Figueiredo LF. Spontaneous cholecystocutaneous fistula: a rare complication of gallbladder disease. Sao Paulo Med J. 2006;124:234–6.CrossRefGoogle Scholar
  2. 2.
    Metsemakers WJ, Quanten I, Vanhoenacker F, Spiessens T. Spontaneous cholecystocutaneous abscess. JBR-BTR. 2010;93:198–200.PubMedGoogle Scholar

Copyright information

© Indian Society of Gastroenterology 2013

Authors and Affiliations

  1. 1.Department of SurgeryGovernment Medical College and HospitalChandigarhIndia

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