Incarcerated Inguinal Hernia Containing a Gallstone Found Decades After a Laparoscopic Cholecystectomy

Iatrogenic gallbladder perforation and subsequent gallstone spillage is a common problem in laparoscopic cholecystectomy. While most commonly asymptomatic, complications due to spilled gallstones have been reported. In this case study, we report the case of a 96-year-old female with a history of laparoscopic cholecystectomy at an unknown time who presented with an incarcerated inguinal hernia and small bowel obstruction. Imaging revealed an extraluminal radiopaque foreign body located near the hernia sac. At the time of the repair, she was found to have a single gallstone located within the hernia sac, confirmed by pathology. The hernia was repaired using Lichtenstein, and her bowel obstruction was resolved postoperatively. Although gallstone spillage from iatrogenic gallbladder perforation during laparoscopic cholecystectomy is a relatively common problem, it is rarely symptomatic and may be associated with infection, abscess, and fistula formation. A rarer complication includes the formation of hernias containing gallstones, documented in fewer than 10 cases in the literature. This case demonstrates a rare consequence of leaving behind spilled gallstones following gallbladder perforation during laparoscopic cholecystectomy. It emphasizes the importance of preventing iatrogenic gallbladder perforation and retrieving any spilled gallstones during the procedure to minimize associated complications.