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Septic lithiasis of the pelvis.
A Protopapas1, S Milingos, E Diakomanolis
1First Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Vas. Sophias 80 and Lourou Street, Athens, Greece. protom@aias.gr
Surgical Endoscopy
|October 26, 2002
Summary
Laparoscopic cholecystectomy can lead to retained gallstones, causing rare pelvic abscesses. This case highlights the importance of considering retained gallstones in post-cholecystectomy patients with unusual abscess locations.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Abdominal Surgery
Background:
- Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones.
- While generally safe, complications like bile duct injury and gallstone spillage can occur.
- Retained gallstones are a known, albeit infrequent, complication linked to delayed infections and abscess formation.
Observation:
- A postmenopausal woman developed an isolated pelvic abscess five months post-laparoscopic cholecystectomy.
- The patient had a history of recurrent cholecystitis.
- The abscess location was unusual, prompting a review of differential diagnoses.
Findings:
- This case presents a rare instance of a pelvic abscess attributed to unretrieved gallstones after laparoscopic cholecystectomy.
- The typical presentation of retained gallstone complications usually involves abscesses in more common abdominal locations.
- Preoperative diagnostic challenges in identifying the source of the pelvic abscess are discussed.
Implications:
- Highlights a rare but serious complication of laparoscopic cholecystectomy: delayed abscess formation from retained gallstones.
- Emphasizes the need for vigilance in diagnosing unusual abscess presentations in patients with a history of cholecystectomy.
- Suggests that retained gallstones should remain in the differential diagnosis for pelvic abscesses, even in the absence of typical symptoms.