Acute right-lower-quadrant mass presenting after laparoscopic cholecystectomy.
Hernia formation at trocar sites has been reported following laparoscopic surgical procedures. We present a case, however, of a healthy woman with signs, symptoms, and physical findings consistent with an incarcerated inguinal hernia 3 days after an uneventful laparoscopic cholecystectomy. Exploratory laparotomy revealed a small bile leak from an accessory duct of Luschka but did not identify an intra-abdominal process responsible for the patient's symptoms. Following the exploration, it was felt that the patient's presentation was likely due to tracking of carbon dioxide and bile-stained irrigation fluid to the right lower quadrant from the lateral laparoscopic trocar sites.
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Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, USA.
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D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001646:Bile; D001652:Bile Ducts / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006552:Hernia, Inguinal / Q000209:etiology; D006801:Humans; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology