• 1.

    Henry CL, Orr TG Jr. Spontaneous external biliary fistulas. Surgery 1949;26:641646.

  • 2.

    Nicholson T, Born MW, Garber E. Spontaneous cholecystocutaneous fistula presenting in the gluteal region. J Clin Gastroenterol 1999;28:276277.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Vasanth A, Aqeel S, O'Donnell K. Spontaneous cholecystocutaneous fistula. South Med J 2004;97:183185.

  • 4.

    Myin JS, Watkins RM. Spontaneous cholecystocutaneous fistula secondary to calculous cholecystitis. Br J Clin Pract 1994;47:341342.

  • 5.

    Reed MWR, Tweedie JH. Spontaneous simultaneous internal and external biliary fistulae. Br J Surg 1985;72:538.

  • 6.

    Matsumoto T, Iwaki K & Hagino Y, et al. Ethanol injection therapy of an isolated bile duct associated with a biliary-cutaneous fistula. J Gastroenterol Hepatol 2002;17:807810.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Andley M, Biswas RS & Ashok S, et al. Spontaneous cholecystocutaneous fistula secondary to calculous cholecystitis. Am J Gastroenterol 1996;1:16561657.

    • Search Google Scholar
    • Export Citation
  • 8.

    Birch BRP, Cox SJ. Spontaneous external biliary fistula uncomplicated by gallstones. Postgrad Med J 1991;67:391392.

  • 9.

    Chang SS, Lu CL & Pan CC, et al. Spontaneous cholecystocutaneous fistula presenting with a cellulites and portal vein thrombosis. J Clin Gastroenterol 2002;34:99100.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Grimes DF, Steinbach HL. Traumatic cholecystocutaneous fistula. AMA Arch Surg 1954;71:6870.

  • 11.

    Callen JP. Cholecystocutaneous fistula. Int J Dermatol 1979;18:6364.

  • 12.

    Rosario P, Gerst P & Prakash K, et al. Cholecystocutaneous fistula: an unusual presentation. Am J Gastroenterol 1990;85:214215.

  • 13.

    Carragher AM, Jackson PR, Panesar KJ. Subcutaneous herniation of gallbladder with spontaneous cholecystocutaneous fistula. Clin Radiol 1990;42:283284.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Sides AA, Bright RM, Mortimer J. Umbilico-biliary fistula in a dog. J Small Anim Pract 2004;45:504506.

  • 15.

    Ulreich S, Henken EM, Levinson ED. Imaging in the diagnosis of cholecystocutaneous fistulae. J Can Assoc Radiol 1983;34:3941.

  • 16.

    Yuceyar S, Erturk S & Karabicak I, et al. Spontaneous cholecystocutaneous fistula presenting with an abscess containing multiple gallstones: a case report. Mt Sinai J Med 2005;72:402404.

    • Search Google Scholar
    • Export Citation
  • 17.

    Neer MT. A review of disorders of the gallbladder and extrahepatic biliary tract in the dog and cat. J Vet Intern Med 1992;6:186192.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Gaillard F, Stella D, Gibson R. Cholecystocolonic fistula diagnosed with CT-intravenous cholangiography. Australas Radiol 2006;50:484486.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Pike FS, Berg J & King NW, et al. Gallbladder mucocele in dogs: 30 cases (2000–2002). J Am Vet Med Assoc 2004;224:16151622.

  • 20.

    Zajko AB, Bennett MJ & Campbell WL, et al. Mucocele of the cystic duct remnant in eight liver transplant recipients: findings at cholangiography, CT, and US. Radiology 1990;177:691693.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

Spontaneous external biliary fistula in a dog

Kara C. KligmanDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126

Search for other papers by Kara C. Kligman in
Current site
Google Scholar
PubMed
Close
 BS
,
Carl T. JehnDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126

Search for other papers by Carl T. Jehn in
Current site
Google Scholar
PubMed
Close
 DVM, MS
,
Kechia M. DavisDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126

Search for other papers by Kechia M. Davis in
Current site
Google Scholar
PubMed
Close
 DVM, DACVS
,
David P. TaylorInfectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126

Search for other papers by David P. Taylor in
Current site
Google Scholar
PubMed
Close
 BVSc, MVS, DACVP
, and
Julia A. ConwayInfectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126

Search for other papers by Julia A. Conway in
Current site
Google Scholar
PubMed
Close
 DVM

Abstract

Case Description—A 10-year-old sexually intact female dog was examined because of a static, well-circumscribed subcutaneous mass and associated fistulous draining tract located along the right ventrolateral aspect of the thoracic body wall of 15 months' duration.

Clinical Findings—Results of computed tomography and fistulography confirmed the presence of the fistulous tract. Computed tomography also revealed a focal, hypodense region in the right ventral portion of the liver that was adjacent to but not clearly associated with the fistulous tract.

Treatment and Outcome—Surgical exploration of the tract revealed that it passed into the right hemithorax to the diaphragm; entered the right medial lobe of the liver; and terminated in a well-encapsulated, cystic liver lesion. The right medial liver lobe and all affected tissues were removed. Histologically, the liver lesion consisted of a fibrotic, dilated bile duct. The dilated bile duct and fistula were lined with biliary epithelium. On the basis of these findings, a diagnosis of spontaneous external biliary fistula was made. Five months after surgery, the dog was clinically normal.

Clinical Relevance—To the authors' knowledge, spontaneous external biliary fistula in a dog has not been reported in the veterinary medical literature. Despite the rarity of this condition, it should be considered in a dog with similar clinical findings. Clinical findings and results of appropriate diagnostic imaging procedures may provide valuable information in making this diagnosis and in planning surgical treatment.

Abstract

Case Description—A 10-year-old sexually intact female dog was examined because of a static, well-circumscribed subcutaneous mass and associated fistulous draining tract located along the right ventrolateral aspect of the thoracic body wall of 15 months' duration.

Clinical Findings—Results of computed tomography and fistulography confirmed the presence of the fistulous tract. Computed tomography also revealed a focal, hypodense region in the right ventral portion of the liver that was adjacent to but not clearly associated with the fistulous tract.

Treatment and Outcome—Surgical exploration of the tract revealed that it passed into the right hemithorax to the diaphragm; entered the right medial lobe of the liver; and terminated in a well-encapsulated, cystic liver lesion. The right medial liver lobe and all affected tissues were removed. Histologically, the liver lesion consisted of a fibrotic, dilated bile duct. The dilated bile duct and fistula were lined with biliary epithelium. On the basis of these findings, a diagnosis of spontaneous external biliary fistula was made. Five months after surgery, the dog was clinically normal.

Clinical Relevance—To the authors' knowledge, spontaneous external biliary fistula in a dog has not been reported in the veterinary medical literature. Despite the rarity of this condition, it should be considered in a dog with similar clinical findings. Clinical findings and results of appropriate diagnostic imaging procedures may provide valuable information in making this diagnosis and in planning surgical treatment.

Contributor Notes

Address correspondence to Dr. Jehn.