{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:11:12Z","timestamp":1756462272049,"version":"3.40.4"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,3,30]]},"abstract":"<jats:p>We present an extremely unusual case of an external biliary fistula in an 87-year-old woman who presented with a 1-day history of spontaneous green discharge from a 60-year-old appendicectomy scar. Examination revealed a sinus in the right iliac fossa overlying her appendicectomy scar, with a raised white cell count and C reactive protein. A CT scan revealed a complex fistula connecting the gallbladder to the subcutaneous tissue in the right flank, which further connected inferiorly with a fistula to the previous appendicectomy scar and a small iliopsoas collection. Endoscopic retrograde cholangiopancreatography revealed several stones in the common bile duct, which were removed using a balloon catheter. The patient was further managed with a long course of antibiotics and discharged with a long-term drainage bag. A literature search revealed no previously reported cases of an external biliary fistula communicating with an appendicectomy scar.<\/jats:p>","DOI":"10.1136\/bcr-2016-214630","type":"journal-article","created":{"date-parts":[[2016,4,12]],"date-time":"2016-04-12T13:58:01Z","timestamp":1460469481000},"page":"bcr2016214630","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["A rare case of gallbladder fistulation with a 60-year-old appendicectomy scar"],"prefix":"10.1136","volume":"2016","author":[{"given":"Gajendiran","family":"Thiruchandran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Joyce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul James","family":"Baggott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,4,12]]},"reference":[{"key":"2025042703111064000_2016.apr12_1.bcr2016214630.1","unstructured":"Clavien PA , Baillie J . Diseases of the gallbladder and bile ducts: diagnosis and treatment. John Wiley & Sons, 2008."},{"key":"2025042703111064000_2016.apr12_1.bcr2016214630.2","doi-asserted-by":"publisher","DOI":"10.1080\/136518201753335584"},{"key":"2025042703111064000_2016.apr12_1.bcr2016214630.3","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-199904000-00024"},{"key":"2025042703111064000_2016.apr12_1.bcr2016214630.4","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjt014"},{"key":"2025042703111064000_2016.apr12_1.bcr2016214630.5","first-page":"1537","article-title":"Diagnosis of acute abdominal pain in older patients","volume":"74","author":"Lyon","year":"2006","journal-title":"Am Fam Physician"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-214630","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:11:21Z","timestamp":1745748681000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-214630"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,12]]},"references-count":5,"alternative-id":["10.1136\/bcr-2016-214630"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-214630","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2016,4,12]]}}}