Middle Pulmonary Lobe Abscess: A Delayed Complication of Laparoscopic Cholecystectomy

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Middle Pulmonary Lobe Abscess: A Delayed Complication of Laparoscopic Cholecystectomy

Nicoleta Leopa, Valerian Cristian Pavaloiu, Mihaela Pundiche, Razvan Bosneagu, Razvan Catalin Popescu
Clinical case, no. 3, 2022
Article DOI: 10.21614/chirurgia.2414
Background: Laparoscopic cholecystectomy has become a routine procedure in abdominal surgery, a "gold standard" in the treatment of gallstones. Iatrogenic perforation of the gallbladder during a cholecystectomy is a possible incident, with numerous complications due to unidentified intraperitoneal gallstones during surgery. Pulmonary complications of laparoscopic cholecystectomy are extremely rare.

Case report: This report presents the case of a 62-year-old female with post cholecystectomy subphrenic abscess and trans-diaphragmatic fistula in the middle pulmonary lobe. In this case, the pulmonary symptoms dominated the clinical picture and the initial complementary explorations indicated a strictly pulmonary condition. The initial evolution of the patient was towards worsening, and the subsequent explorations established the real diagnosis.

Conclusion: Gallbladder perforations with accidental loss of gallstones should be recognized immediately and managed. In the development of a pulmonary abscess, we can take into account an intra-peritoneal condition as well.

Keywords: retained gallstones, delayed complication, lung abscess