Perihepatic, Pulmonary, and Renal Abscesses Due to Spilled Gallstones

Publication date: Available online 4 February 2017
Source:The Journal of Emergency Medicine
Author(s): Jacob Lentz, Maria A. Tobar, Caleb P. Canders
BackgroundSpilled gallstones are common during laparoscopic cholecystectomy; however, they rarely lead to postoperative complications. Perihepatic abscesses develop in < 0.1% of patients with spilled gallstones and are typically contained within the peritoneal cavity.Case ReportWe present a 57-year-old man with history of cholecystectomy 2 years prior who presented with cough and flank pain and was discovered to have a perihepatic abscess invading his lung and kidney secondary to a spilled gallstone.Why Should Emergency Physicians Be Aware of This?Although most perihepatic abscesses can be treated with percutaneous drainage and antibiotics, abscesses secondary to spilled gallstones usually require open or laparoscopic surgery to drain the abscess and retrieve the gallstone. Prompt identification of spilled gallstones in patients with intra-abdominal and intrathoracic abscesses can thereby guide disposition and decrease morbidity and mortality.



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