Intra-abdominal abscess from dropped gallstone: A case report

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Abdominal Imaging
• Infectious Disease

Background:

• Laparoscopic cholecystectomy is a common procedure, but dropped gallstones can occur as a complication.
• While usually asymptomatic, dropped gallstones can lead to rare but serious complications like intra-abdominal abscess.
• Prompt recognition and management are essential to prevent morbidity.

Observation:

• A patient presented with symptoms of acute cholecystitis and acute abdomen two months post-laparoscopic cholecystectomy.
• Elevated white blood cell count (WBC) and C-reactive protein (CRP) indicated an inflammatory process.
• Ultrasound and contrast-enhanced CT scans suggested an intra-abdominal abscess.

Findings:

• The intra-abdominal abscess was confirmed intraoperatively via laparoscopy.
• Dropped gallstones were identified as the likely nidus for the abscess formation.
• This case highlights a rare but significant complication of dropped gallstones.

Implications:

• Emphasizes the importance of meticulous surgical technique to minimize gallstone spillage during laparoscopic cholecystectomy.
• Highlights the role of advanced imaging (ultrasound, CT) in diagnosing abscesses secondary to dropped gallstones.
• Underscores the need for clinicians to consider dropped gallstones in the differential diagnosis of intra-abdominal abscesses in patients with a history of cholecystectomy.