General Surgery, Weston General Hospital, Weston-super-Mare, North Somerset, UK
General Surgery, Weston General Hospital, Weston-super-Mare, North Somerset, UK.
BMJ Case Rep. 2021 Feb 5;14(2):e234191. doi: 10.1136/bcr-2019-234191.
We describe the case of a 78-year-old woman who presented to the emergency department with a 2-week history of a superficially developing mass in the lower right abdominal wall, fluctuant and non-tender with overlaying erythematous skin changes. Though resembling an abdominal wall abscess and initially listed for a simple incision and drainage, diagnostic uncertainty encouraged further investigation. CT and ultrasound confirmed the mass appeared to be in continuity with the gallbladder fossa, with the lumen also containing small bowel medially. While awaiting a multidisciplinary team discussion, the patient re-presented with concern over discharge appearing at the site of the mass. On inspection, we noted black flecks and small stones. This case describes the unusual and rare presentation of a cholecystocutaneous fistula. The patient was managed conservatively and remains clinically well.
我们描述了一位 78 岁女性的病例，她因右下腹部有一两周的浅表肿块、波动感且无触痛、伴有红斑性皮肤改变而到急诊科就诊。尽管该肿块类似于腹壁脓肿，最初被列为单纯切开引流，但由于诊断不确定，鼓励进一步进行检查。CT 和超声检查证实该肿块似乎与胆囊窝连续，其管腔内部也有小肠。在等待多学科团队讨论时，患者再次出现对肿块部位出现渗液的担忧。检查时，我们注意到黑色斑点和小结石。本例描述了一种罕见的胆囊皮肤瘘的异常表现。该患者接受了保守治疗，目前临床状况良好。
