Dropped Gallstones Causing a Perihepatic Abscess and Empyema

Iatrogenic perforation of the gallbladder during laparoscopic cholecystectomy is a well-known occurrence; however, the consequences of spillage of gallstones in the peritoneum and particularly intrathoracic complications are less defined. We describe the delayed development of a perihepatic abscess...

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Main Authors: J. R. Robinson, J. K. Wright, S. K. Geevarghese
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2015/629704
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author J. R. Robinson
J. K. Wright
S. K. Geevarghese
author_facet J. R. Robinson
J. K. Wright
S. K. Geevarghese
author_sort J. R. Robinson
collection DOAJ
description Iatrogenic perforation of the gallbladder during laparoscopic cholecystectomy is a well-known occurrence; however, the consequences of spillage of gallstones in the peritoneum and particularly intrathoracic complications are less defined. We describe the delayed development of a perihepatic abscess and empyema in a patient five years following laparoscopic cholecystectomy secondary to dropped gallstones. A 53-year-old man with medical history significant for a laparoscopic cholecystectomy five years prior to acute cholecystitis presented with purulent cough, hemoptysis, night sweats, and right-upper quadrant (RUQ) pain. Computed tomography (CT) scan revealed 5.4 cm right-sided subpulmonic and 5.9 cm perihepatic fluid collections with an 8 mm focal radiopaque density within the perihepatic fluid collection. Open intra-abdominal exploration resulted in retrieval of a 1 cm intraperitoneal gallstone. Laparoscopic cholecystectomy is a common surgical operation during which gallstone spillage can occur, causing both intra-abdominal and intrathoracic complications, presenting even years after surgery. This necessitates an attempt to retrieve all free intra-abdominal gallstones during the initial operation.
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spelling doaj-art-6a4f261616b64984a42f1d9d97c834b92025-08-20T03:33:39ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/629704629704Dropped Gallstones Causing a Perihepatic Abscess and EmpyemaJ. R. Robinson0J. K. Wright1S. K. Geevarghese2Department of General Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USADepartment of General Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USADepartment of General Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USAIatrogenic perforation of the gallbladder during laparoscopic cholecystectomy is a well-known occurrence; however, the consequences of spillage of gallstones in the peritoneum and particularly intrathoracic complications are less defined. We describe the delayed development of a perihepatic abscess and empyema in a patient five years following laparoscopic cholecystectomy secondary to dropped gallstones. A 53-year-old man with medical history significant for a laparoscopic cholecystectomy five years prior to acute cholecystitis presented with purulent cough, hemoptysis, night sweats, and right-upper quadrant (RUQ) pain. Computed tomography (CT) scan revealed 5.4 cm right-sided subpulmonic and 5.9 cm perihepatic fluid collections with an 8 mm focal radiopaque density within the perihepatic fluid collection. Open intra-abdominal exploration resulted in retrieval of a 1 cm intraperitoneal gallstone. Laparoscopic cholecystectomy is a common surgical operation during which gallstone spillage can occur, causing both intra-abdominal and intrathoracic complications, presenting even years after surgery. This necessitates an attempt to retrieve all free intra-abdominal gallstones during the initial operation.http://dx.doi.org/10.1155/2015/629704
spellingShingle J. R. Robinson
J. K. Wright
S. K. Geevarghese
Dropped Gallstones Causing a Perihepatic Abscess and Empyema
Case Reports in Surgery
title Dropped Gallstones Causing a Perihepatic Abscess and Empyema
title_full Dropped Gallstones Causing a Perihepatic Abscess and Empyema
title_fullStr Dropped Gallstones Causing a Perihepatic Abscess and Empyema
title_full_unstemmed Dropped Gallstones Causing a Perihepatic Abscess and Empyema
title_short Dropped Gallstones Causing a Perihepatic Abscess and Empyema
title_sort dropped gallstones causing a perihepatic abscess and empyema
url http://dx.doi.org/10.1155/2015/629704
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