Cholecystocutaneous Fistula Associated with Necrotizing Fasciitis of the Abdominal Wall: A Case Report

Abstract

Cholecystocutaneous fistula represents an extremely rare complication of calculous cholecystopathy. In the past 50 years, less than 50 cases have been reported. The most frequent site of spontaneous cholecystocutaneous fistula is the right hypochondrium, followed by the left hypochondrium, periumbilical, right lumbar, right iliac fossa and gluteal areas. The association with necrotizing fasciitis that represents a serious infection, characterized by extensive and rapidly progressive necrosis, affecting the subcutaneous plane and reaching the muscular fascia provides a high mortality rate and extensive procedures are required. Herein we present a case of a 64-years-old, female, admitted to the emergency department with complaint of diffuse, severe abdominal pain, associated with a tense and painful lesion in the abdominal wall with the diagnose of cholecystocutaneous fistula associated with necrotizing fasciitis that despite an aggressive surgical approach developed a multisystem failure and died 24 hours after admission.