Brief clinical report: duodenal laceration presenting as massive hematemesis and multiple intraabdominal abscesses after laparoscopic cholecystectomy.
Laparoscopic cholecystectomy is considered the gold standard for gallstone disease. Nevertheless, possible severe complications must not be underestimated. Bowel injuries are uncommon, but they are one of the most lethal technical complications of laparoscopic surgery. These injuries were commonly unrecognized at the time of procedures and were diagnosed later when the patients experienced sepsis, peritonitis, intraabdominal abscess, or enterocutaneous fistula. Although duodenal lacerations have been reported with laparoscopic cholecystectomies, they seem to be rare; approximately 30 such cases have been documented previously in the English literature. We report the case of a patient with thermal duodenal injury caused by elective laparoscopic cholecystectomy at an outside center presenting as massive hematemesis and multiple intraabdominal abscesses on the ninth postoperative day. The diagnosis and management of this rare complication of laparoscopic cholecystectomy are described, and the literature is reviewed.
Avrutis
O
O
Department of Surgery, Bikur Cholim Hospital, 5 Strauss Street, Jerusalem 91004, Israel. mjack@netvision.net.il
Meshoulam
J
J
Yutkin
O
O
Mikchalevski
V
V
Haskel
L
L
Adler
S
S
Durst
A
A
D018784:Abdominal Abscess / Q000209:etiology* / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D002764:Cholecystitis / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage / Q000379:methods; D004386:Duodenum / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006396:Hematemesis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome