Dilemma of Diagnosis of Right Hypochondrium Sinus Tract-Unusual Presentation of Spontaneous Cholecysto-Cutaneous Fistula

Abstract

Cholecysto-cutaneous fistula is an abnormal communication between the gallbladder and the skin. cholecystocutaneous fistula is defined as a gallbladder communication with the external environment through the abdominal wall rupture;(6) It is not very common and may be the result of complications of acute cholecystitis, gallbladder malignancy, post-operative ie iatrogenic injury. A 74-year-old male presented to us with the complaint of discharging sinus in the right hypochondrium quadrant of the abdomen with a history of pain and swelling since 5 months. Patient had a history of drainage of swelling and is now having continuous seropurulent discharge from the incision site. Biliary discharge is confirmatory of biliary fistula, but serous discharge without any inflammatory sign gives a dilemma about diagnosis. Subcostal right-sided fistulous opening with serosanguinous discharge is a diagnostic dilemma, and cholecysto-cutaneous fistulas are one of them. One should always be aware and treat such cases after proper diagnostic evaluation and full consideration of appropriate treatment.