Case of cholecystocutaneous fistula complicating calculous cholecystitis in a patient with no past history of surgery.

The patient mentioned that she has small stones coming out from this fistula, According to patient's family, she had an abdominal ultrasound 23 years ago which showed cholelithiasis but the patient refused the surgery at that time.

External biliary fistulas are extremely rare, only few cases were reported in the literature and usually are the result of neglected cholelithiasis (as in this case). Other causes include gallbladder neoplasms and post surgical complications (such as percutaneous cholecystostomy). 

Treatment includes cholecystectomy, resection of the fistulous track, and repair of abdominal wall defect.