A case report: Delayed gallstone abscess formation 10 years post-cholecystectomy

Abstract

Introduction: Retained gallstones post-cholecystectomy act as a nidus for abscess formation. It is unusual for intraabdominal abscesses to remain asymptomatic due to its propensity to cause inflammation and irritation to the peritoneum.

Presentation of case: A 73-year-old female presented with acute onset of right-sided abdominal pain and fever. Her past surgical history was significant for a cholecystectomy in 2010, hysterectomy, and partial nephrectomy. She was diagnosed with an intraabdominal abscess secondary to a retained gallstone post-cholecystectomy. She underwent laparoscopic surgery to drain and remove the abscess. The patient's abdominal pain improved, remains afebrile, and is passing stool regularly.

Discussion: Gallbladder perforation is common and is dependent on the integrity of the gallbladder and surrounding structures. It is unusual for an intra-abdominal abscess to develop so late following gallstone spillage. This example brings to light the potential long-term sequelae of gallbladder perforation and future complications.

Conclusion: This case highlights the importance of irrigation of the peritoneal cavity and retrieval any spilled gallstones during surgery in the event of gallbladder perforation.

Keywords: Abscess; Cholecystectomy; Gallstones; Laparscopic surgery.