Surgical clip found at duodenal ulcer after laparoscopic cholecystectomy: report of a case.
Surgical clips may incorporate into the duodenal ulcer after laparoscopic cholecystectomy leading to a rare complication.


METHODS
A 70-year-old woman, 15 years after laparoscopic cholecystectomy, developed weight loss, anemia and gastric outlet obstruction secondary to a chronic duodenal ulcer. Gastroscopy showed a clip in the ulcer bed. At surgery she was found to have gastric outlet obstruction and mobilization of the duodenum revealed a large ulcer with a migrated clip from the cystic duct in its base. The ulcer was excluded and the clip was removed. She was perfectly well at the follow-up after 2 months.


CONCLUSIONS
Migration of endo-surgical clips is a rare complication after laparoscopic surgery. Surgeons, gastroenterologists and radiologists should be aware of this late complication of laparoscopic cholecystectomy in cases of acute abdominal symptoms.
Samim
Mehdi M
MM
Department of Surgery, St. James University Hospital, Leeds, United Kingdom.
Armstrong
Christopher P
CP
D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000295:instrumentation; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D005548:Foreign-Body Migration / Q000150:complications*; D006801:Humans; D013525:Surgical Instruments / Q000009:adverse effects*