Acute Cholecystitis Presenting as a Subcutaneous Abscess and Sepsis

A 67-year-old female presented with vague abdominal pain, renal failure, and sepsis. A CT scan without contrast was obtained and subcutaneous fluid was seen along with a large calcified gallstone. After antibiotics, fluid resuscitation and dialysis, the patient was taken to the operating room where a large subcutaneous abscess was found. The abdominal wall was debrided and an open cholecystectomy was attempted. Because of dense adhesions and inflammation, a cholecystostomy tube was placed. The patient required a skin graft after her abdominal wall debridement. Her gallbladder was removed 4 months later. This patient presented with a rare complication of acute cholecystitis - gallbladder rupture into the subcutaneous tissues. In this manuscript, we discuss this case and the literature.