Snapshot quiz 13/28

Published: 03/21/2013

Authors: Bajwa Z, Chishti I and Siddiqui M

This 59-year-old patient presented with a 2-week history of increasing right upper abdominal pain, swelling and pyrexia. He had a cholecystectomy 4 years previously. Computed tomography identified a large complex abdominal fluid collection. The perihepatic and intra-abdominal abscesses were drained surgically. A gallstone fragment seen in the abscess cavity was the focus of infection. Although a perihepatic collection of this nature is relatively uncommon, it should be noted as a possible outcome of cholecystectomy even years after the original surgery. It highlights the importance of documentation of spilled stones during surgery and their extraction.