Chronic percutaneous gallstone discharge following videothoracoscopic decortication

Computed tomographic imaging is not recommended as an essential prerequisite in surgery for pleuro-pulmonary sepsis in the current guidelines. We highlight one consequent pitfall and its sequelae. We report the discharge of gallstones through a healed intercostal drain site four months following video-assisted thoracic surgery for early pleural empyema secondary to missed calculous gallstone disease. The importance of awareness and a high index of suspicion to diagnose the underlying extra-thoracic cause of a right-sided pleural collection in a patient with a previous history of gallstone disease cannot be overemphasised.