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腹腔镜胆囊切除术后6年出现的胆囊结石相关腹部囊性肿块:病例报告

Gallstone-related abdominal cystic mass presenting 6 years after laparoscopic cholecystectomy: A case report.

作者信息

Faour Rama, Sultan Dana, Houry Rand, Faour Mhamad, Ghazal Ahmad

机构信息

University of Aleppo, Faculty of Medicine, Aleppo, Syria.

University of Aleppo, Faculty of Medicine, Aleppo, Syria.

出版信息

Int J Surg Case Rep. 2017;32:70-72. doi: 10.1016/j.ijscr.2017.01.059. Epub 2017 Feb 11.

Abstract

INTRODUCTION

Although gallbladder perforation and gallstones spillage are common complications during laparoscopic cholecystectomy (LC), clinically significant complications resulting from stones left in the peritoneum are extremely uncommon. We report a rare case of spilled gallstones complication with a late and uncharacteristic presentation.

PRESENTATION OF THE CASE

A 44-year-old Caucasian female presented with a complaint of a mass in the right upper quadrant associated with a cramping pain for the last 6 months. Her past surgical history included a laparoscopic cholecystectomy performed six years ago. Abdominal computed tomography demonstrated an intra-abdominal cystic mass. On open exploration, a cystic mass adhered to the abdominal wall was excised containing two gallstones. The patient tolerated the procedure well and had uneventful postoperative recovery.

DISCUSSION

Although unretrieved gallstones are considered harmless, serious complications can occur early or late. The most frequent complication is the formation of abscesses in different locations.

CONCLUSION

The diagnosis of gallstone abscess after years of LC is usually a diagnostic challenge. Obtaining a comprehensive past surgical history still plays an important role in the assessment of patients presenting with unusual findings.

摘要

引言

尽管胆囊穿孔和胆结石溢出是腹腔镜胆囊切除术(LC)期间常见的并发症,但因结石残留于腹膜而导致的具有临床意义的并发症极为罕见。我们报告一例罕见的胆结石溢出并发症,其表现较晚且不典型。

病例介绍

一名44岁的白人女性主诉右上腹有肿块,并伴有痉挛性疼痛,持续6个月。她过去的手术史包括6年前进行的腹腔镜胆囊切除术。腹部计算机断层扫描显示腹内有一个囊性肿块。在开放探查时,切除了一个附着于腹壁的囊性肿块,其中含有两颗胆结石。患者对手术耐受良好,术后恢复顺利。

讨论

尽管未取出的胆结石被认为无害,但早期或晚期都可能发生严重并发症。最常见的并发症是在不同部位形成脓肿。

结论

LC术后数年胆结石脓肿的诊断通常是一项诊断挑战。获取全面的既往手术史在评估出现异常表现的患者时仍起着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d24d/5333506/575a874132a2/gr1.jpg

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