Gallstones split at laparoscopic cholecystectomy: a new cause of intraperitoneal granulomas.
A case of a 32 year old woman with a foreign body-type granulomatous reaction to gallstones split at previous laparoscopic cholecystectomy is reported. The patient presented with hard nodules within the omentum at a subsequent Caesarean section, raising the possibility of metastatic tumour. Histological examination showed gallstones with an associated foreign body-type granulomatous reaction. With increasingly widespread use of laparoscopic surgery and relatively common spillage of gallstones at surgery, it is likely that histopathologists will encounter this condition more frequently in the future, both in surgical biopsy specimens and at necropsy.
Warren
C W
CW
Department of Histopathology, St James's University Hospital, Leeds.
Wyatt
J I
JI
D000328:Adult; D002585:Cesarean Section; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002769:Cholelithiasis / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000473:pathology; D006801:Humans; D009852:Omentum; D010532:Peritoneal Diseases / Q000209:etiology / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000175:diagnosis; D011247:Pregnancy