Cases reported "Cholelithiasis"

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11/108. Intra-abdominal gallstone spillage detected during umbilical trocar site hernia repair after laparoscopic cholecystectomy: report of a case.

    It is well known that spilled gallstones may occur as a complication during laparoscopic cholecystectomy. We present herein the case of a patient in whom intra-abdominal gallstone spillage was found during repair of an incisional hernia at the umbilical trocar port site 3 months after a laparoscopic cholecystectomy. We describe this case and present a review of the recent literature to stress the importance of preventing stone spillage and retrieving any stones that are spilled into the abdomen.
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ranking = 1
keywords = intra-abdominal
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12/108. Intraperitoneal abscess after an undetected spilled stone.

    gallbladder perforation with loss of calculi in the abdomen is frequent during laparoscopic cholecystectomy and can cause serious late complications. We report on a 65-year-old woman who underwent laparoscopic cholecystectomy for gallbladder empyema, during which a stone spilled into the peritoneal cavity. The spilled gallstone was not noticed during the initial operation. Three months later, she reported left upper quadrant pain of recent onset without associated symptoms such as fever, nausea, or weight loss. On examination, a palpable 2-cm tender subcutaneous mass was found. Abdominal ultrasound demonstrated an incarcerated hernia, and computed tomography (CT) scan showed an intraperitoneal abscess located in the back of the anterior abdominal wall in the left upper quadrant, which contained a recalcification figure. The patient was brought to surgery, at which time an incision was made over the mass. A chronic abscess in the back of the abdominal wall, also spreading into the subfascial space, was drained, and purulent material was obtained with a large stone, 2.8 cm in diameter, which had become lodged in the rectus abdominis after an undetected stone spillage during laparoscopic cholecystectomy. The patient continued receiving antibiotic treatment for 7 days, recovered well, and was discharged 7 days after drainage of the abscess.
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ranking = 56.679511022778
keywords = abscess
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13/108. Gallstone in abdominal wall--a complication of laparoscopic cholecystectomy.

    A 39-year-old woman presented with abdominal wall mass 9 years after she underwent laparoscopic cholecystectomy for symptomatic gallstones. After surgical resection, a pathologic examination identified an abscess cavity within the abdominal wall that was surrounded by a wide, diffuse, poorly defined wall of dense fibrous tissue. An examination did not show neoplastic tissue. The cavity was bile-stained and contained a 2.5-cm gallstone. This case shows a complication of laparoscopic cholecystectomy. gallstones spilled during the extraction of the gallbladder through the abdominal wall incision may lead to a reactive process that clinically and microscopically may resemble a fibro-proliferative disorder, including a neoplastic process. This complication of laparoscopic cholecystectomy is rare. Pathologists must be aware of its occurrence because examination of the solid fibrous wall may lead to diagnoses of reactive or neoplastic fibro-proliferative processes.
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ranking = 8.097073003254
keywords = abscess
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14/108. Laparoscopic cholecystectomy and the Peter Pan syndrome.

    We report the case of a patient who experienced hemobilia a few weeks after undergoing laparoscopic cholecystectomy (LC). This condition was due to the rupture of a pseudo-aneurysm of the right hepatic artery in the common bile duct, probably caused by a clip erroneously fired during LC on the lateral right wall of the vessel. It also caused the formation of multiple liver abscesses and the onset of sepsis. This life-threatening complication led to melena, fever, epigastric pain, pancreatitis, liver dysfunction, and severe anemia, requiring urgent hospitalization and operation. In the operating theater, the fistula was closed, the liver abscesses drained, and a Kehr tube inserted. Thereafter, the patient's general condition improved, and she is now well. LC is often considered to be the gold standard for the management of symptomatic cholelithiasis. However, recent data have undermined that opinion. The apparent advantages offered by LC in the short term (less pain, speedier recovery, shorter hospital stay, and lower costs) have been overwhelmed by the complications that occur during long-term follow-up. When the late downward trend in the bile duct and the vascular injury rate are taken into consideration, the learning curve is prolonged. Therefore, LC should be regarded as the surgical equivalent of a modern Peter Pan-i.e., it is like a young adult who should make definitive steps toward becoming an adult but does not succeed in doing so. We report the case of a patient who experienced hemobilia a few weeks after undergoing laparoscopic cholecystectomy. Based on the facts in this case, we argue that the endoscopic procedure still needs to be perfected and cannot yet be considered the gold standard for selected cases of gallstone disease.
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ranking = 16.194146006508
keywords = abscess
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15/108. Extraction of retained gallstones from an abscess cavity: a percutaneous endoscopic technique.

    A novel technique to retrieve spilled gallstones in an abscess cavity with the use of minimally invasive techniques is described.
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ranking = 40.48536501627
keywords = abscess
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16/108. Recurrent septic episodes following gallstone spillage at laparoscopic cholecystectomy.

    A 51-year-old woman underwent emergency laparoscopic cholecystectomy. Stone loss occurred during gallbladder dissection. histology showed empyema of the gallbladder. Postoperatively, she developed a subhepatic abscess that required percutaneous drainage. Two years after surgery, she re-presented with a right paracolic abscess. Transsciatic CT-guided drainage of the abscess was performed. barium enema excluded colonic pathology. Two weeks later, she developed a right gluteal abscess deep to the recent drain site. Ultrasound-guided drainage was performed followed by a sonogram. The sonogram ruled out communication with the peritoneum. Two further subhepatic abscesses occurred during the next 5 years; the first abscess was drained percutaneously, but the second required open drainage: At laparotomy, gallstone fragments were found within the abscess cavity. The site of the previous gluteal drain continued to discharge intermittently. An MRI scan showed an uncomplicated sinus track. Subsequent sinography of the right gluteal track demonstrated an opacity at the apex of the sinus. The sinus was laid open and a gallstone retrieved. The patient has remained well for 3 years. Complications due to gallstone spillage generally manifest themselves shortly after surgery. This case demonstrates that lost stones may cause chronic abdominal and abdominal wall sepsis. In cases of chronic abdominal sepsis after laparoscopic cholecystectomy, the possibility of lost stones should be considered even if stones are not positively shown on imaging.
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ranking = 56.679511022778
keywords = abscess
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17/108. abdominal wall abscess secondary to spilled gallstones: late complication of laparoscopic cholecystectomy and preventive measures.

    Spilled gallstones left in the abdominal cavity or trapped at trocar sites may cause considerable morbidity. We saw a patient with an abdominal wall abscess 2 years after laparoscopic cholecystectomy secondary to spilled stones. After we reviewed the operative procedure in addition to the accumulated experience in laparoscopic surgery, we believe that retrieval of specimens and their contents is of paramount importance, especially when the gallbladder is infected, contains several stones, or may harbor malignancy. Therefore, we made use of a simple surgical glove with a long pursestring suture surrounding the opening to collect the specimen. This method proved to be simple and quite convenient, with the needed materials readily available. It can collect the spilled stones within the abdominal cavity as well as the gallbladder and can transport these stones out of the abdominal cavity with ease and safety. It also protects the specimen in contact with the wound and cuts short the operating time. The technique and advantages are described.
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ranking = 40.48536501627
keywords = abscess
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18/108. Percutaneous treatment of gallstone abscess after laparoscopic cholecystectomy using fistuloscopy.

    A 69-year-old man with a low-grade fever and right upper quadrant pain was diagnosed as having two gallstone abscesses after laparoscopic cholecystectomy. One lesion healed after stones spontaneously passed through the drainage tube, and the other lesion healed after percutaneous removal of stones using fistuloscopy. The patient's course was uneventful as of 29 months after percutaneous treatment.
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ranking = 40.48536501627
keywords = abscess
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19/108. Massive hemoptysis from a lung abscess due to retained gallstones.

    This case report describes a subhepatic abscess from spilled gallstones which eroded through the diaphragm causing a right lower lobe pulmonary abscess and presenting as massive hemoptysis.
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ranking = 48.582438019524
keywords = abscess
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20/108. Recurrent abscess at site of laparoscopic cholecystectomy port due to spilled gallstones.

    Spillage of gallstones is common during laparoscopic cholecystectomy and may lead to intra-abdominal abscesses and sinus formation. We describe two patients with recurrent abscess at the site of epigastric port due to presence of large spilled stone in the parietes following laparoscopic cholecystectomy. Removal of the stone led to resolution of symptoms.
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ranking = 1112.3373258038
keywords = abdominal abscess, abscess, intra-abdominal
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