Xanthogranulomatous panniculitis after spillage of gallstones during laparoscopic cholecystectomy mimics intra-abdominal malignancy.
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.
Lin
Chien-Hua
CH
Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chu
Heng-Cheng
HC
Hsieh
Huan-Fa
HF
Jin
Jong-Shiaw
JS
Yu
Jyh-Cherng
JC
Cheng
Ming-Fang
MF
Hsu
Sheng-Der
SD
Chan
De-Chuan
DC
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*