Cholecystocutaneous fistulas are abnormal fistulous connection between the gallbladder and the skin. It is a rare form of gastrointestinal fistulation and may result from a complication of cholecystitis, gallbladder carcinoma, or percutaneous procedures 1,2.
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Epidemiology
The peak incidence is in the 7th decade, with an increased prevalence in the female population 1. Cholecystocutaneous fistulas are decreasing in frequency, due to improvements in medical imaging techniques and treatment of gallbladder disease 2. Fistulas relating to percutaneous cholecystostomy drains are a rare subset with two previous reports in the literature 2,3.
Clinical presentation
The most common external location of fistula is the right upper quadrant 1. Common presenting symptoms include fever, nausea, vomiting or localized pain, swelling and discharge 1.
Radiographic features
US
May demonstrate a tract or associated abnormal findings, including thickened gallbladder wall or abscess 1.
CT
The tract may enhance on post-contrast images.
Treatment and prognosis
Treatment options include conservative management, cholecystectomy, and fistula excision 2,3. Surgery may be performed via open or laparoscopic approaches.
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