Perihepatic, Pulmonary, and Renal Abscesses Due to Spilled Gallstones.
BACKGROUND
Spilled gallstones are common during laparoscopic cholecystectomy; however, they rarely lead to postoperative complications. Perihepatic abscesses develop in < 0.1% of patients with spilled gallstones and are typically contained within the peritoneal cavity.


METHODS
We present a 57-year-old man with history of cholecystectomy 2 years prior who presented with cough and flank pain and was discovered to have a perihepatic abscess invading his lung and kidney secondary to a spilled gallstone. WHY SHOULD EMERGENCY PHYSICIANS BE AWARE OF THIS?: Although most perihepatic abscesses can be treated with percutaneous drainage and antibiotics, abscesses secondary to spilled gallstones usually require open or laparoscopic surgery to drain the abscess and retrieve the gallstone. Prompt identification of spilled gallstones in patients with intra-abdominal and intrathoracic abscesses can thereby guide disposition and decrease morbidity and mortality.
Department of Emergency Medicine, UCLA Medical Center, Los Angeles, California.
Jacob
J
Lentz
The David Geffen School of Medicine at UCLA, Los Angeles, California.
Maria A
MA
Tobar
Department of Emergency Medicine, UCLA Medical Center, Los Angeles, California.
Caleb P
CP
Canders
D018784:Abdominal Abscess / Q000209:etiology* / Q000503:physiopathology; D002763:Cholecystectomy / Q000009:adverse effects; D003371:Cough / Q000209:etiology; D021501:Flank Pain / Q000209:etiology; D042882:Gallstones / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000601:surgery
laparoscopic cholecystectomy complications; perihepatic abscess; pulmonary abscess; renal abscess; spilled gallstone