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病例报告:胆囊切除术后10年出现延迟性胆结石脓肿形成。

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

作者信息

Quinn Erina, Capanegro James, Hartigan Joseph

机构信息

Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA.

Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA.

出版信息

Int J Surg Case Rep. 2020;77:903-905. doi: 10.1016/j.ijscr.2020.11.126. Epub 2020 Nov 30.

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.

摘要

引言

胆囊切除术后残留胆结石是脓肿形成的病灶。腹腔内脓肿因易引起腹膜炎症和刺激而通常不会无症状。

病例介绍

一名73岁女性因突发右侧腹痛和发热就诊。她既往手术史包括2010年的胆囊切除术、子宫切除术和部分肾切除术。她被诊断为胆囊切除术后残留胆结石继发腹腔内脓肿。她接受了腹腔镜手术以引流和清除脓肿。患者的腹痛改善,不再发热,排便正常。

讨论

胆囊穿孔很常见,取决于胆囊及周围结构的完整性。胆结石溢出后这么晚才发生腹腔内脓肿并不常见。这个例子揭示了胆囊穿孔潜在的长期后遗症和未来并发症。

结论

该病例强调了在胆囊穿孔手术期间对腹腔进行冲洗并取出任何溢出胆结石的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f6b/7732970/49a0aed8a3c6/gr1.jpg

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