Spontaneous cholecysto-umbilical fistula

Spontaneous external biliary fistulae are now extremely rare events because of the relative safety of early treatment of biliary tract disease. We report a case of painless, spontaneous cholecysto-umbilical fistula which presented with no previous history of biliary disease. A woman aged 66 was admitted on 8th September, 1983 with a persistent discharge from the umbilicus. Two months earlier she had complained of umbilical irritation and rash followed by discharge, initially slight and watery. Within two days she started to pass “gravel” via the umbilicus and this persisted for seven days and then stopped. The description of this gravel was consistent with gall stones. Since then she had had an increasing discharge of bile from the umbilicus.