title: Xanthogranulomatous panniculitis after spillage of gallstones during laparoscopic cholecystectomy mimics intra-abdominal malignancy.
abstract: Spillage of gallstones into the peritoneal cavity during laparoscopic cholecystectomy (LC) occurs frequently and may be associated with complications. Most of these complications present late after the original procedure, and many have clinical pictures that are not related to biliary etiology, which can confound and delay adequate management. Our patient presented with an intra-abdominal firm heterogeneous mass lesion. Imaging studies showed obvious abdominal wall invasion, and CA-125 level was elevated. Thus, malignancy could not be excluded. Final operative pathology revealed xanthogranulomatous inflammation. Complications of LC should be considered for patients with intra-abdominal abscess or mass lesion if there is a history of LC, regardless of time interval.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Lin
authors.forename: Heng-Cheng
authors.initials: HC
authors.lastname: Chu
authors.forename: Huan-Fa
authors.initials: HF
authors.lastname: Hsieh
authors.forename: Jong-Shiaw
authors.initials: JS
authors.lastname: Jin
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Cheng
authors.forename: Sheng-Der
authors.initials: SD
authors.lastname: Hsu
authors.forename: De-Chuan
authors.initials: DC
authors.lastname: Chan
mesh_terms: D000008:Abdominal Neoplasms / Q000175:diagnosis*; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000601:surgery*; D006099:Granuloma / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D015434:Panniculitis / Q000175:diagnosis* / Q000209:etiology*; D014973:Xanthomatosis / Q000175:diagnosis* / Q000209:etiology*