A rare case of gallbladder fistulation with a 60-year-old appendicectomy scar.

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.

Confidentiality issues in patients who have misinformed their families.

As medical practitioners, we occasionally encounter patients who have misinformed their families of their medical histories. We describe a case of a patient whose age is in the mid-40s, who we believe had factitiously constructed a serious illness. This patient had suffered an acute exacerbation of chronic asthma and later died.