Total Hip Lithiasis: A Rare Sequelae of Spilled Gallstones

Area of Science:

• Surgical complications
• Infectious disease
• Orthopedic surgery

Background:

• Laparoscopic cholecystectomy is standard for gallstones and acute cholecystitis.
• Gallstone spillage during surgery can cause abscesses in various body locations.
• Iliopsoas abscesses and infected hip prostheses are serious complications.

Observation:

• A patient developed a right iliopsoas abscess and infected hip prosthesis after laparoscopic cholecystectomy.
• CT imaging revealed acetabular shell overmedialization and perforation.
• Gallstones were found deep to the acetabulum during prosthesis explantation.

Findings:

• Gallstone spillage from laparoscopic cholecystectomy can lead to deep-seated infections, including iliopsoas abscesses.
• Acetabular component overmedialization in hip arthroplasty can create a pathway for infection.
• The presence of gallstones contributed to the infection of the hip prosthesis.

Implications:

• Surgeons must carefully avoid acetabular overmedialization during hip arthroplasty to prevent infectious complications.
• Recognizing gallstone spillage as a potential source of deep infection is crucial.
• This case underscores the importance of meticulous surgical technique in preventing rare but severe post-cholecystectomy complications.