Published: 2022-01-29

Acute calculous cholecystitis complicated by a large anterior abdominal wall abscess

Zanis Bordo, Arta Berzina, Kaspars Zeiza


We present a 74-year-old male patient with a rare case of acute calculous cholecystitis that was complicated by formation of a large anterior abdominal wall abscess due to neglection. The primary management consisted of antibiotic therapy and two consequent procedures of abscess drainage. Cholecystectomy was postponed due to the massive volume of the abscess which posed a great risk for complications if the patient were to be operated on at that point, therefore an elective open cholecystectomy was performed 3 months later. This case is a good example for the management of such a rare and interesting complication.


Acute calculous cholecystitis, Abdominal wall abscess

Full Text:



Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002;325(7365):639-43.

Alsaman MZB, Mazketly M, Ziadeh M, Aleter O, Ghazal A. Cholecystocutaneous fistula incidence, Etiology, Clinical Manifestations, Diagnosis, and treatment. A literature review. Ann Med Surg. 2020;59:180-5.

Tinay OE, Siddiqui ZUR, Alhedaithy M, Kharashgah MNM. Right hypochondrial abscess: A rare consequence of supportive cholecystitis. Ann Med Surg. 2016;12:106-8.

Bloom AA, Anand BS. Cholecystitis Treatment & Management. Available at: Accessed on 15 September 2021.

Malik AH, Nadeem M, Ockrim J. Complete laparoscopic management of cholecystocutaneous fistula. Ulster Med J. 2007;3:166-7.

Chowksey SR, Baghel H, Sharma P, Singh B. Diagnosis of Gallbladder Perforation—a Puzzle! Indian J Surg. 2014;76(3):247-50.

Mutignani M, Iacopini F, Perri V, Familiari P, Tringali A, Spada C, Ingrosso M, Costamagna G. Endoscopic gallbladder drainage for acute cholecystitis: technical and clinical results. Endoscopy. 2009;41(6):539-46.

Li M, Li N, Ji W, Quan Z, Wan X, Wu X, Li J, et al. Percutaneous cholecystostomy is a definitive treatment for acute cholecystitis in elderly high-risk patients. Am Surg. 2013;79(5):524-7.

Flora HS, Bhattacharya S. Spontaneous cholecystocutaneous fistula. HPB. 2001;3(4):279-80.

Silberfein EJ, Zhou W, Kougias P, El Sayed HF, Huynh TT, Albo, et al. Percutaneous cholecystostomy for acute cholecystitis in high-risk patients: experience of a surgeon-initiated interventional program. Am J Surg. 2007;194(5):672-7.