Cholecystocutaneous Fistula: A Rare Complication of Gallbladder Disease - A Case Report

Abstract

Spontaneous cholecystocutaneous abscess or fistula is an exceptionally rare consequence of gallbladder
disease, with fewer than 100 cases reported in the literature. The condition was first described by Thelisus in
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1670, and later, Courvoisier documented 169 occurrences of biliary fistulas in the 19th century . Biliary
2
fistulas, which can be internal or external, often arise as a complication of acute calculus cholecystitis. From
suppurative cholecystitis with spontaneous rupture to surgical external drainage of an abscess, the disease's
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natural course has changed due to medical and surgical interventions have significantly altered its course .
The primary underlying mechanism involves obstruction of bile outflow due to gallstones, which increases
intra gallbladder pressure, disrupts lymphatic drainage, and compromises gallbladder wall circulation. These
pathophysiological changes contribute to necrosis and subsequent fistula formation. If perforation occurs,
bile leakage may lead to a localized peritoneal abscess or extend externally through the abdominal wall
.Early and effective management of biliary tract disease is critical to preventing this uncommon but severe
complication.