BACKGROUND:Cholecystocolocutaneous ifstula (CCCF) is a rare complication of gallstone disease resulting from spillage of gallstones from perforation of an empyema of the gallbladder, which can pose diagnostic dilemmas. We describe a patient, who presented initially with a swelling followed by discharging sinuses on her right lfank where a diagnosis of CCCF was made and was treated surgically with satisfactory outcome. METHODS: A computed tomography (CT) scan showed an ill-deifned soft tissue mass in the right subhepatic space and a ifstulogram demonstrated passage of contrast into the gallbladder fossa and hepatic lfexure of colon. At laparotomy, a cutaneous ifstula containing two pigment stones led to the gallbladder fossa and hepatic lfexure of colon. RESULTS: Debridement of infected granulation tissues which had replaced the gallbladder, closure of the cystic duct stump and colonic ifstula followed by excision of the ifstula tract led to complete resolution. CONCLUSIONS:CCCF is a rare complication of perforated gallbladder with spillage of calculi, and a ifstulogram is helpful in establishing the diagnosis. This case highlights the importance of retrieving spilled stones following interventions in the gallbladder to prevent the complication.