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Intraperitoneal abscess after an undetected spilled stone.
C Simopoulos1, A Polychronidis, S Perente
1Second Department of Surgery, Democritus Thrace University, District General Hospital of Alexandroupolis, 19 Dimitras Str, 681 00 Alexandroupolis, Greece. csimopoulos@hotmail.com
Surgical Endoscopy
|March 27, 2001
Summary
A spilled gallstone during laparoscopic cholecystectomy caused a delayed abdominal abscess and hernia in a 65-year-old woman. Surgical drainage and antibiotics successfully treated the complication, highlighting the importance of detecting retained gallstones.
Area of Science:
- Surgical complications
- Gastroenterology
- Abdominal imaging
Background:
- Laparoscopic cholecystectomy is a common procedure for gallbladder diseases.
- Gallbladder perforation with retained gallstones can lead to delayed complications.
- Accurate intraoperative detection of spilled gallstones is crucial.
Observation:
- A 65-year-old woman developed left upper quadrant pain three months after laparoscopic cholecystectomy.
- Imaging revealed an intraperitoneal abscess and an incarcerated hernia containing a gallstone.
- The gallstone was suspected to have spilled during the initial surgery.
Findings:
- Surgical exploration identified a chronic abscess in the abdominal wall containing a 2.8 cm gallstone.
- The gallstone had migrated and lodged within the rectus abdominis muscle.
- The abscess was successfully drained, and the patient received antibiotic treatment.
Implications:
- This case underscores the potential for serious late complications from undetected gallstone spillage during laparoscopic cholecystectomy.
- Prompt diagnosis and surgical management are essential for treating such delayed presentations.
- Vigilance during laparoscopic procedures to prevent and identify gallstone loss is paramount.