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Intrathoracic gallstones: a case report and literature review
Jacques P Fontaine1, Roger A Issa, Rhonda K Yantiss
1Division of Thoracic Surgery, University of Massachusetts Medical Center, Worcester, Massachusetts, USA.
Background:
Laparoscopic cholecystectomy is one of the most commonly performed procedures in general surgery. There have been very few reported thoracic complications from this surgical procedure.
Methods:
We report the case of a patient who underwent a laparoscopic cholecystectomy with gallstone spillage 34 months before presenting to the thoracic surgery service. The patient first complained of streaks of hemoptysis at 6 months from the time of the original procedure. A lower lobe infiltrate was noted and treated successfully with oral antibiotics. Over the next 2 years, the patient's symptoms waxed and waned.
Results:
Due to the chronic infiltrate in his lung, a thoracotomy was performed that revealed erosion of the stone through the right diaphragm with formation of a lung abscess.
Conclusion:
A high index of suspicion for a gallstone-related problem should be entertained by the practitioner when presented with a patient who has a right lung infiltrate and a history of open or laparoscopic cholecystectomy.
