New problems

Lumbar fistula secondary to biliary lithiasis abandoned during laparoscopic surgery

  • Daniel González Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Quirúrgica 3. Profesor Adjunto
  • Gustavo Rodríguez Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Quirúrgica 3. Profesor Agregado
  • Luis Ruso Universidad de la República, Facultad de Medicina, Hospital Maciel, Clínica Quirúrgica 3. Profesor Titular
Keywords: LAPAROSCOPIC CHOLECYSTECTOMY, FISTULA, ABDOMINAL ABSCESS, GALLBLADDER, GALLSTONES

Abstract

Cholecystechtomy laparoscopy to treat lithiasis of the accessory bile duct has been seen to be accompanied by a new complication resulting from abandoning the lithiasis and clips in the peritoneal cavity. This complication is also related to the accidental perforation of the gall bladder, either during cholecystechtomy or its removal. This study presents a clinical case where abandonment of the biliary lithiasis which resulted from breaking the nylon bag during vesicular removal in a laparoscopic cholecystechtomy coordinated 22 months prior to consultation, determined a right lumbar abscess which spontaneously drained causing a fistulous tract with constant drainage. During intraoperative exploration of the fistula, a 5 mm biliary lithiasis was found and removed, and the procedure was completed with a fistulectomy, what enabled scarring and consequently, the final resolution of the symptoms.

References

(1) Castellón-Pavón CJ, Morales-Artero S, Martínez-Pozuelo A, Valderrábano-González S. Complicaciones por cálculos y clips intraabdominales abandonados durante una colecistectomía laparoscópica. Cir Esp 2008; 84(1): 3-9.
(2) Horton M, Florence MG. Unusual abscess paterns following dropped gallstones during laparoscopic cholecystectomy. Am J Surg 1998; 175(5): 375-9.
(3) Sosa Quesada Y, Bueno Lledó J, Vaqué Urbaneja J, Baquero Valdelomar R. Absceso perihepático secundario a cálculo biliar olvidado en cavidad abdominal. Cir Esp 2008; 83(4): 216-7
(4) Iannitti DA, Varker KA, Zaydfudim V, McKee J. Subphrenic and pleural abscess due to spilled gallstones. JSLS 2006; 10(1): 101-4.
(5) Hougård K, Bergenfeldt M. Abdominal fistula 7 years after laparoscopic cholecystectomy. Ugeskr Laeger 2008; 170(36): 2803.
(6) Pantanowitz L, Prefontaine M, Hunt JP. Cholelithiasis of the ovary after laparoscopic cholecystectomy: a case report. J Reprod Med 2007; 52(10): 968-70.
(7) Hand AA, Self ML, Dunn E. Abdominal wall abscess formation two years after laparoscopic cholecystectomy. JSLS 2006; 10(1): 105-7.
(8) Aspelund G, Halldórsdóttir BA, Isaksson HJ, Möller PH. Gallstone in a hernia sac. Surg Endosc 2003; 17(4): 657.
(9) Yadav RK, Yadav VS, Garg P, Yadav SP, Goel V. Gallstone expectoration following laparoscopic cholecystectomy. Indian J Chest Dis Allied Sci 2002; 44(2): 133-5.
(10) Famulari C, Pirrone G, Macrì A, Crescenti F, Scuderi G, De Caridi G, et al. The vesical granuloma: rare and late complication of laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 2001; 11(6): 368-71.
(11) Castro MG, Alves AS, Oliveira CA, Vieira Júnior A, Vianna JL, Costa RF. Elimination of biliary stones through the urinary tract: a complication of the laparoscopic cholecystectomy. Rev Hosp Clin Fac Med São Paulo 1999; 54(6): 209-12.
(12) Arishi AR, Rabie ME, Khan MS, Sumaili H, Shaabi H, Michael NT, et al. Spilled gallstones: the source of an enigma. JSLS 2008; 12(3): 321-5.
(13) Parra-Davila E, Munshi IA, Armstrong JH, Sleeman D, Levi JU. Retroperitoneal abscess as a complication of retained gallstones following laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech A 1998; 8(2): 89-93.
(14) Sichardt G, Bindewald H. Paranephritic abscess. Local late complication after laparoscopic cholecystectomy. Chirurg 1996; 67(7): 754-6.
(15) de Hingh IH, Gouma DJ. Diagnostic image (345). A woman with abdominal pain nd purulent vaginal discharge. Ned Tijdschr Geneeskd 2007; 151(41): 2271.
Published
2010-12-31
How to Cite
1.
González D, Rodríguez G, Ruso L. New problems. Rev. Méd. Urug. [Internet]. 2010Dec.31 [cited 2024Dec.18];26(4):253-6. Available from: https://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/414

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