Drahman Aizat, Arulpragasam Kaushi, Leibenson Lilach, Sardelic Frank
Department of Surgery, Royal Prince Alfred Hospital, 2050 Sydney, New South Wales, Australia.
Department of Obstetrics and Gynaecology, King Edward Memorial Hospital, 6008 Subiaco, Western Australia, Australia.
Case Rep Surg. 2021 Jul 19;2021:5553994. doi: 10.1155/2021/5553994. eCollection 2021.
Assessing abdominal pain, particularly in women of reproductive age, requires thorough history taking, clinical examination, and investigations to obtain an accurate diagnosis. Both surgical and gynecological causes need to be considered, particularly previous relevant surgical history. We report a case of pelvic pain secondary to multiple gallstones found within the pelvic cavity postlaparoscopic cholecystectomy. Thorough investigations have been conducted without any obvious cause found. The pain was debilitating and largely affecting the patient's quality of life. Therefore, decision to perform diagnostic laparoscopy and gallstones was found all over pelvic cavity and retrieved. Her pain resolved post operatively.
Gallbladder perforation and stone spillage are the most common complications of laparoscopic cholecystectomy that arise during the removal and dissection of gallbladder and can cause significant morbidity if not managed early, especially retrieval of the stones intraoperatively. Therefore, patient with history of previous cholecystectomy with stone spillage presenting with undifferentiated abdominal pain and early diagnostic laparoscopy should be considered.
评估腹痛,尤其是育龄期女性的腹痛,需要详细的病史采集、临床检查和相关检查以获得准确诊断。需要考虑外科和妇科病因,尤其是既往相关手术史。我们报告一例腹腔镜胆囊切除术后盆腔内发现多发胆结石继发盆腔疼痛的病例。已进行全面检查,但未发现任何明显病因。疼痛使人衰弱,严重影响患者生活质量。因此,决定进行诊断性腹腔镜检查,发现盆腔内布满胆结石并予以取出。术后患者疼痛缓解。
胆囊穿孔和结石散落是腹腔镜胆囊切除术最常见的并发症,发生于胆囊切除和分离过程中,如果不及早处理,尤其是术中取出结石,可导致严重发病。因此,对于有胆囊切除术和结石散落史且出现不明原因腹痛的患者,应考虑早期诊断性腹腔镜检查。