Gupta Amit, Joshua Manoj, Kumar Navin, Chauhan Udit, Gupta Sweety
Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India.
Department of Radiology, All India Institute of Medical Sciences, Rishikesh, India.
Pol Przegl Chir. 2019 Dec 9;92(5):1-5. doi: 10.5604/01.3001.0013.6277.
Spontaneous Cholecystocutaneous Fistula occurs as a result of complication from untreated gall bladder stone disease infrequently seen in surgical practice due to early diagnosis of gall stone disease with imaging and appropriate and prompt antibiotic and surgical treatment.
We report our experience with a 40-year-old woman who presented with a yellowish discharge from the umbilicus. Abdominal examination revealed a sinus opening at the umbilicus with the yellowish discharge and a vague mass in the right hypochondrium. CT fistulogram showed tract extending form the umbilicus to the gall bladder. Open cholecystectomy with excision of the fistulous tract was carried out. Histopathological examination showed chronic inflammation of the gall bladder with the fistulous tract lined by inflammatory granulation tissue. Post-operative recovery was normal and uneventful. The patient was normal in follow-up. Cholecystocutaneous fistula is a rare clinical entity. The diagnosis is established with CT and MRCP. Surgery remains the mainstay of treatment.
自发性胆囊皮肤瘘是胆囊结石病未经治疗而引发的并发症,由于借助影像学手段可对胆结石病进行早期诊断,并能及时进行恰当的抗生素及手术治疗,所以在外科实践中这种情况并不常见。
我们报告了一位40岁女性患者的情况,她的脐部有淡黄色分泌物。腹部检查发现脐部有一个窦口,伴有淡黄色分泌物,右季肋部有一个模糊的肿块。CT瘘管造影显示瘘管从脐部延伸至胆囊。实施了开放性胆囊切除术并切除瘘管。组织病理学检查显示胆囊有慢性炎症,瘘管内衬炎性肉芽组织。术后恢复正常且顺利。患者在随访中情况正常。胆囊皮肤瘘是一种罕见的临床病症。通过CT和磁共振胰胆管造影(MRCP)来确诊。手术仍是主要的治疗方法。