EURORAD ESR

Case 14646

Spontaneous cholecystocutaneous fistula with a subcutaneous gallstone: a case report

Author(s)
Dr. S. Vanden Berghe 1, Dr. P. Seynaeve 2

1. Department of Radiology, University Hospitals, Leuven, Belgium
Email: simonvdberghe@gmail.com
2. AZ Groeninge Hospital, Kortrijk, Belgium
 
Patient
female, 93 year(s)
 
 
  • Figure 1
    Plain abdominal radiography

    Plain abdominal radiography shows a round calcified structure in the right lumbar region. This calcified structure projects lateral and caudal to the gallbladder fossa. There is a normal bowel gas pattern.

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Calcifications / Calculi;
     
     
  • Figure 2
    Axial CT

    Axial CT image at the level of the gallbladder. An inflamed gallbladder with hyperattenuating wall is seen, along with a fistula trajectory that arises from the gallbladder and extends to the subcutaneous fat.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
  • Figure 3
    Coronal CT

    Coronal CT image shows the subcutaneous abscess with a hyperattenuating inflamed wall and homogeneous hypodense content. The radioopaque gallstone can be seen in the subcutaneous compartment. 

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
  • Figure 4
    Paracoronal CT

    Paracoronal CT image demonstrates the fistula trajectory. The gallstone has eroded through the inflamed gallbladder wall, has migrated through the fistula that perforates the abdominal wall and resides in the...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
Plain abdominal radiography shows a round calcified structure in the right lumbar region. This calcified structure projects lateral and caudal to the gallbladder fossa. There is a normal bowel gas pattern.
 
Axial CT image at the level of the gallbladder. An inflamed gallbladder with hyperattenuating wall is seen, along with a fistula trajectory that arises from the gallbladder and extends to the subcutaneous fat.
 
Coronal CT image shows the subcutaneous abscess with a hyperattenuating inflamed wall and homogeneous hypodense content. The radioopaque gallstone can be seen in the subcutaneous compartment. 
 
Paracoronal CT image demonstrates the fistula trajectory. The gallstone has eroded through the inflamed gallbladder wall, has migrated through the fistula that perforates the abdominal wall and resides in the subcutaneous component of the fistula.
 
 
 
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