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Scott Med J ; 64(2): 67-70, 2019 May.
Article in English | MEDLINE | ID: mdl-30373501

ABSTRACT

INTRODUCTION: Dropped gallstones are gallstones lost in the abdominal cavity during cholecystectomy. They are a rare occurrence and often cause minimal long-term issues. However, it is recognised that dropped stones can cause intra- or extra-abdominal sepsis. We present three cases below which highlight this. CASES: All three cases describe patients presenting for laparoscopic cholecystectomy, Cases 1 and 2 post-gallstone pancreatitis and Case 3 for gallbladder stones. Cases 1 and 3 presented nine months and five years post-operatively, respectively, with flank abscess. Both received CT scans, with incision and drainage performed to remove gallstone. Case 2 presented six weeks post-operatively with cough and breathlessness. CT scan showed pleural effusion with communication to subphrenic collection. Pus and gallstone fragments were drained. CONCLUSION: The above cases highlight that despite the majority of patients remaining asymptomatic, dropped gallstones should be considered amongst the differential in patients presenting with intra- or extra-abdominal abscess post-cholecystectomy, with timely intervention key to management.


Subject(s)
Abdominal Wall , Abscess/etiology , Cholecystectomy, Laparoscopic/adverse effects , Empyema, Pleural/etiology , Foreign Bodies/complications , Gallstones/complications , Aged , Aged, 80 and over , Female , Gallstones/surgery , Humans , Male , Middle Aged
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