Faecolith migrating from the appendix to produce liver abscess after subhepatic laparoscopic appendectomy

The subhepatic position of an appendix may lead to difficulty in diagnosis of appendicitis, its surgical management as well as bizarre complications. A 'lost' appendicular faecolith is not an uncommon complication due to spillage during the removal of the appendix or due to perforation. Here we report a case of such a faecolith migrating into the liver parenchyma following intraoperative hepatic injury, and producing a liver abscess. The calcified lesion seen in the liver corresponded to a free-lying faecolith on a preoperative computed tomography scan. Liver abscess was presumed to arise from implantation of this foreign object into the liver parenchyma. Pigtail drainage of abscess was performed with good result.