Cholecystocutaneous abscess: diagnostic difficulty in a groin lump

Abstract

An older patient presented with a 4-week history of tender lump in the right groin. Appearances were consistent with strangulated inguinal hernia and theatre was arranged. At operation, the lump was found to be an abscess communicating with the abdominal cavity. Alternative diagnosis requiring further operative management was considered but consent was deemed inadequate to proceed. Operation was abandoned and CT examination arranged. CT unexpectedly identified a cholecystocutaneous abscess discharging through the right inguinal region. The patient made good clinical recovery with ongoing drainage of the abscess and did not require any further operative treatment.

Figure 1

CT showing abscess tracking from gallbladder to right groin (arrow). Oblique sagittal view.