A complicated abscess from a dropped gallstone

Abstract

Laparoscopic cholecystectomies represent one of the most common procedures of General Surgery. Dropped gallstones during laparoscopic cholecystectomy is a rare occurrence but can potentially lead to morbid complications. We present a rare case of a broncho-pleuro-cutaneous fistula in a patient with recurrent abscess formations after an elective laparoscopic cholecystectomy. The fistula formed over 3 years from a gallstone that eroded through the diaphragm, into the pleural space, and eventually into a terminal bronchiole. Bilirubin staining within the fistula tract was confirmed on hematoxylin and eosin staining.

“Target sign” from dropped gallstones after laparoscopic cholecystectomy

“…Laparoscopic cholecystectomy is the procedure of choice for gallbladder removal in patients with uncomplicated gallstones [1 , 2 , 6 , [9] , [10] , [11] , 14 , 15] . The laparoscopic approach is preferred to the open surgical approach because it has fewer complications and lower mortality in the perioperative period along with reduced length of stay in the hospital [9] .…”