A 70-year-old man with an empyema

Thoracic empyema after laparoscopic cholecystectomy: an unusual cause

Thoracic empyema after laparoscopic cholecystectomy is a rare complication. It is associated with dropped gallstones during the operation. In this case, we report a hepatocellular adenoma hemorrhage underneath an old diaphragm rupture, causing empyema after laparoscopic cholecystectomy.

Multilocular Flank Abscess Due to Stone Migration Following Laparoscopic Cholecystectomy with Spillage of Gallstones

We report a case of a patient who presented with a large flank abscess 18 months after laparoscopic cholecystectomy. The patient underwent repeated percutaneous drainage but the abscess recurred. Further evaluation with ultrasound revealed subcutaneous tracks from the flank leading to the abdominal cavity and suspected stones in one of the tracks. Laparoscopy revealed dense adhesions at the level of the right gutter leading to a retroperitoneal track heading over to the flank. The tracks were partially opened, debrided, and two gallstones were retrieved from one of the retroperitoneal tracks. The patient's recovery was uneventful. This case demonstrates the potential migration of dropped gallstones to extraperitoneal sites leading to infectious complications. Careful dissection of the gallbladder with an attempt not to rupture it is important in order to prevent this complication. Once rupture does occur, efforts should be made to retrieve dropped stones from the peritoneal cavity. Patients presenting with intra- or extraperitoneal abscesses following laparoscopic cholecystectomy and no obvious source of infection should be evaluated for dropped stones.

Dropped Gallstone as a Nidus of Intra-abdominal Abscess Complicated by Empyema

We describe a patient who developed an intra-abdominal abscess and empyema from a dropped gallstone at the time of laparoscopic cholecystectomy 1.5 years ago. As minimally invasive surgeries become conventional, clinicians should be aware of this increasingly common complication.

[Recurrent pneumonia and empyema due to Klebsiella pneumoniae as a complication of laparoscopic cholecystectomy]

We report a patient with pneumonia and empyema secondary to an abdominal abscess due to Klebsiella pneumoniae from stones released into the abdominal cavity during laparoscopic cholecystectomy.

Radiologic features of complications arising from dropped gallstones in laparoscopic cholecystectomy patients

OBJECTIVE

Because laparoscopic cholecystectomy has become the accepted treatment for symptomatic cholelithiasis, radiologists frequently encounter patients who have had this surgery. Although the radiologic features of postoperative bile duct injury are well documented, the imaging features of less well-known complications remain poorly described. One such unusual complication is abscess formation caused by dropped gallstones.

CONCLUSION

Although the incidence of dropped gallstones is an uncommon complication of laparoscopic cholecystectomy, it should be recognized as a potential source of both intraabdominal and intrathoracic abscess formation in any patient presenting months to years after undergoing laparoscopic cholecystectomy. These abscesses are not necessarily confined to the right upper quadrant.