A Case of an Intractable Cutaneous Fistula Caused by a Gallstone Dropped During a Previous Laparoscopic Cholecystectomy

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We report a case of an abscess in the lateral abdominal wall and an intractable cutaneous fistula due to a gallstone lost in a laparoscopic cholecystectomy (LC) performed two years earlier. A 74-year-old man who had undergone an LC for cholelithiasis and chronic cholecystitis two years previously was seen at the hospital because of a right flank tumor after an uneventful postoperative course. Under the diagnosis of an abscess within the right oblique muscles, debridement and drainage were performed, but purulent discharge persisted from the wound site for more than three months. An abdominal CT scan showed a low density area in the right lateral abdominal wall and on the lateral surface of the right lobe of the liver. A fistulography revealed a fistula extending up to the lateral and inferior surface of the liver and around the radiolucent area denoting a lost gallstone. As the abscess and fistula were considered to be caused by the gallstone dropped during the previous LC, we removed the stone, and performed a fistulotomy and peritoneal drainage. The patient recovered uneventfully and has been free from recurrence for four years after the operation.
日本腹部救急医学会の論文