title: Faecolith migrating from the appendix to produce liver abscess after subhepatic laparoscopic appendectomy.
abstract: The subhepatic position of an appendix may lead to difficulty in diagnosis of appendicitis, its surgical management as well as bizarre complications. A 'lost' appendicular faecolith is not an uncommon complication due to spillage during the removal of the appendix or due to perforation. Here we report a case of such a faecolith migrating into the liver parenchyma following intraoperative hepatic injury, and producing a liver abscess. The calcified lesion seen in the liver corresponded to a free-lying faecolith on a preoperative computed tomography scan. Liver abscess was presumed to arise from implantation of this foreign object into the liver parenchyma. Pigtail drainage of abscess was performed with good result.
authors.affiliation: Consultant, Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Devendra
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Consultant, Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar rm_subbu2000@yahoo.com.
authors.forename: Subramaniyan
authors.initials: S
authors.lastname: Ramanathan
authors.affiliation: Consultant, Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al Faki
authors.affiliation: Specialist, Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Nepal
mesh_terms: D001062:Appendectomy / Q000009:adverse effects*; D001064:Appendicitis / Q000601:surgery*; D001065:Appendix / Q000002:abnormalities; D004322:Drainage; D005243:Feces; D006801:Humans; D007049:Iatrogenic Disease; D010535:Laparoscopy; D008100:Liver Abscess / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
keywords: Appendicular faecolith; hepatic injury; laparoscopic appendectomy; liver abscess; subhepatic appendicitis