An octogenarian presented to her primary care physician with hemoptysis and a disabling chronic cough that developed several months after a complicated partial cholecystectomy. During investigation, a biopsy sample showed a right lower lobe inflammatory mass containing bile pigment and abundant neutrophils. Thoracotomy performed approximately 18 months after symptom onset confirmed a right lower lobe lung abscess together with a large gallstone embedded at its center and a healed defect in the right hemidiaphragm. A wedge excision of this mass was performed. The patient made an excellent uncomplicated recovery from this rare complication of a gallbladder operation.
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