scholarly journals Intraperitoneal Granulomas Unexpectedly Found during a Cesarean Delivery: A Late Complication of Dropped Gallstones

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
David A. Suarez-Zamora ◽  
Luis E. Barrera-Herrera ◽  
Ricardo Caceres-Mileo ◽  
Mauricio A. Palau-Lazaro
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Foreign Body ◽  
Cesarean Delivery ◽  
Histological Examination ◽  
Abdominal Cavity ◽  
Late Complication ◽  
Body Type ◽  
Neoplastic Tissue ◽  
Interpretation Errors ◽  
Granulomatous Response

Laparoscopic cholecystectomy is the treatment of choice for patients with symptomatic cholelithiasis. Spillage of gallstones into the abdominal cavity during laparoscopic cholecystectomy occurs in approximately one-third of cases. Although retained gallstones remain asymptomatic, few cases may develop complications. We report the case of a 29-year-old nulliparous woman presenting with several hard nodules in the omentum, raising the possibility of a metastatic disease. Histological examination demonstrated a bile-stained material and a foreign body-type granulomatous response without neoplastic tissue. Our case demonstrates an example of a complication resulting two years after a laparoscopic cholecystectomy that was unexpectedly found during a cesarean delivery. Pathologists should be aware of this entity to avoid interpretation errors.

Foreign Body Granulomatous Response to Particulate Bony Debris

1996 ◽  
Vol 09 (03) ◽  
pp. 119-25
Author(s):  
Z. Ish-Shalom ◽  
I. Misselevich ◽  
D. G. Mendes ◽  
J. H. Boss
Keyword(s):  
Foreign Body ◽  
Granulation Tissue ◽  
Bone Allograft ◽  
Giant Cells ◽  
Body Type ◽  
Artificial Joints ◽  
Foreign Body Giant Cells ◽  
Type Giant ◽  
Granulomatous Response ◽  
Massive Bone

SummaryArchival material was retrieved in order to histologically assess the body’s response to micron-sized, necrotic bony particles. Specimens were obtained from (1) human bone grafts in a subcutaneous or muscular pouch of athymic nude mice, (2) a massive bone allograft replacing a patient’s humerus, (3) rabbits’ healing tibial cortical bone defects littered with finely dispersed bony particles, (4) periprosthetic tissues of patient’s aseptically loosened artificial joints and (5) interfacial membranes of intramedullary nails used for fixation of patients’ fractured long bones. Necrotic bony debris was found to induce a giant celled granulomatous reaction. In sections of undecalcified samples stained by the von Kossa method, small calcific particles were observed to be present within polykaryonic macrophages (foreign body giant cells) and surrounded by mononuclear macrophages. It is concluded that a foreign body-type giant celled granulation tissue participates in the degradation of micron-sized, necrotic bony detritus, whether the disintegrating bone is of the xeno-, alio- or autogenic provenance.Histological examination of von Kossa-stained sections, of undecalcified specimens, revealed a giant celled granulomatous response to bony debris. Irrespective of whether or not the disintegrating bone was of auto-, alio- or xenogeneic provenance, micron-sized bony particles were found to be phagocytosed by polykaryonic macrophages of the granulation tissue.

scholarly journals Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

1970 ◽  
Vol 7 (1) ◽  
pp. 26-30 ◽  
Author(s):  
R Gabriel ◽  
S Kumar ◽  
A Shrestha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Predictive Factors ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Bladder Wall ◽  
Patient Factors ◽  
College Hospital ◽  
Biliary Pain ◽  
Conversion Rates

Background: Laparoscopic cholecystectomy has now replaced open cholecystectomy for the treatment of gallbladder diseases. However, certain cases still require conversion to open procedures. This study identifies and evaluates risk factors that may predict conversion from laparoscopic to an open procedure. Objectives: To identify and evaluate the predictive factors for conversion of laparoscopic to open cholecystectomy. Materials and methods: A total of 234 Laparoscopic cholecystectomies were attempted at the Kasturba Medical College Hospital, Manipal, from January 2003 to July 2005. Of these, 61 had to be converted to open cholecystectomy. A retro and prospective analysis of different parameters, including Patient factors, Intra-operative factors and Surgeon factors were performed. Results: Sixty one (26.1%) laparoscopic cholecystectomies required conversion. Factors contributing to conversion included male sex, age group of 31-40 years, over weight and history of biliary pain within last two to four months, ultrasonography findings of multiple calculi and gall bladder wall thickness of more than 3 mm. Intraoperative gall bladder perforation with spillage of its contents in abdominal cavity and dense adhesions with difficult anatomy resulted in higher conversion rates. Surgery performed by surgeons in learning phase of laparoscopic surgery was more prone to conversion. Conclusion: Patient factors, presentation, preoperative ultrasonography findings and surgeon's experience, all contribute to the possibility of conversion of laparoscopic cholecystectomy. Knowledge of these factors may help in preinformation to patient for psychological preparations for conversion and an experienced surgeon can plan to operate on these patients. Key words: Cholecystectomy, laparoscopy, conversion. doi: 10.3126/kumj.v7i1.1761       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 26-30     

scholarly journals Rare complications of intrauterine contraception with formation of foreign bodies in the abdominal cavity and urine bladder

2004 ◽  
Vol 53 (4) ◽  
pp. 86-88
Author(s):  
V. М. Subbotin ◽  
М. I. Davidov
Keyword(s):  
Foreign Body ◽  
Female Patient ◽  
Foreign Bodies ◽  
Abdominal Cavity ◽  
Complete Recovery ◽  
Uterine Wall ◽  
Intrauterine Contraception ◽  
Trophic Changes ◽  
Urine Bladder

2 rare cases of intrauterine contraception are presented. A 53-year old female patient had been having a Lippas intrauterine contraception device (IUCD) in the abdominal cavity for 19 years before it was occasionally revealed on cholecystectomy. The next female patient who had had a T-type IUCD for 6 years developed trophic changes of the uterine wall followed by the migration and penetration of IUCD into the wall and then the urine bladder cavity. Laparotomy and cystotomy with the evacuation of the foreign body and dissection of the walls of cystouterine fistular were performed. Both patients made a complete recovery.

A STUDY OF COMPARISON OF PURE TISSUE REPAIR (DESERDA) AND PROSTHETIC REPAIR (LICHTENSTEIN) METHODS FOR INGUINAL HERNIA REPAIR-A COMPARATIVE STUDY

2021 ◽  
pp. 1-4
Author(s):  
Harish Chauhan ◽  
Daxesh Patel ◽  
Nishan Gaudani
Keyword(s):  
Chronic Pain ◽  
Foreign Body ◽  
Hernia Repair ◽  
Operative Time ◽  
Late Complication ◽  
Normal Activity ◽  
Foreign Body Sensation ◽  
Prosthetic Repair ◽  
Body Sensation

INTRODUCTION: An ideal hernia repair should be tension free, tissue based, with no potential damage to vital structures, no long term pain or complications and no recurrence. Although Lichtenstein's prosthetic repair is simple and safe, but it is also correlated with risk of infections, recurrence, chronic pain, testicular atrophy and infertility, foreign body sensations and chronic groin sepsis. Desarda hernia repair does not require mesh and provide more physiological support. It is simple, easy to learn. AIMS AND OBJECTIVES: a) To compare the operative time, postoperative stay and time required to return normal activity between two groups. b) To compare early complication rate and late complication rate between two groups. MATERIALAND METHODS: This observational study was conducted among patients admitted with the diagnosis of primary inguinal hernia in SMIMER, Surat. The patients were randomly allocated to either Lichtenstein or Desarda method of hernia repair. Operating time, post operative stay and duration of return to normal activity were recorded. Early complications were noted and the patients were followed up to 12 months for late complications (chronic pain, foreign body sensation, and recurrence). RESULTS: The mean operative time and postoperative stay did not show signicant differ for both groups. Patients operated by Desarda technique returned to normal activity signicantly early by 12.2 ± 2.54 days as compared to patients operated by Lichtenstein techniques (14.0 ± 2.76 days, p = 0.01). Most common early complication in both groups was pain (D group; 40.0%, Lgroup: 45.2%) followed by wound infection (D group; 8.0%, Lgroup: 6.5%) and seroma (D group; 0.0%, Lgroup: 3.2%). Occurrence of chronic pain was more in Lgroup (58.1%) as compared to D group (16.0%, p=0.001). None of the patients from D group had foreign body sensation. Foreign body sensation was observed only in ve patients of Lgroup (16.1%). Recurrence rate during one year in Lgroup (6.5%) was higher than D group (4.0%). CONCLUSION: Early return to work was potential benet of Desarda repair. Early complications were similar in both procedures. Desarda repair has lower incidence of chronic pain and foreign body sensation. However, there is no signicant difference for chronic pain in Desarda group when compared in same patients operated bilaterally with different technique. This study was conducted with small sample size with short follow up. Therefore, result of late complication in the present study may insufcient to conclude the probability of occurrence as longer follow up and larger sample size is required.

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

2020 ◽  
Author(s):  
Lesheng Huang ◽  
Hongyi Li ◽  
Jun Chen ◽  
Jinghua Jiang ◽  
Wanchun Zhang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Left Lobe ◽  
Port Site ◽  
Laparoscopic Port ◽  
Missed Diagnosis ◽  
Upper Abdominal

Abstract Introduction: Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, a serious but rare condition may be happened, which is the missed diagnosis of intraperitoneal malignant tumor. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to the abdominal cavity or the abdominal wall. The missed laparoscopic malignant tumors are prone to metastasis, especially at the laparoscopic port-site. More extreme condition will be located in the navel, which is known as Sister Mary Joseph’s nodule(SMJN).Case presentation: A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that the most of tumor markers were increased. CT scan revealed that there was a diffused irregular and progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and multiple nodular lesions were found under the costal margin of the right upper abdominal wall, right lower abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed an infiltrative or metastatic middle differentiated adenocarcinoma. So the diagnosis was left lobe cholangiocarcinoma of the liver, multiple lymph nodes metastasis in the abdominal cavity and multiple implant metastasis in abdominal wall laparoscopic port-site and umbilical.Conclusion: In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, like gallstone in biliary system, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor or other lesions. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all the organs and tissues in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

scholarly journals Right lumbar abscess containing a gallstone—an unexpected late complication of laparoscopic cholecystectomy

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
André Marçal ◽  
Ricardo Vaz Pereira ◽  
Ana Monteiro ◽  
José Dias ◽  
António Oliveira ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Late Complication ◽  
Late Complications ◽  
Gallbladder Perforation ◽  
Past Medical History ◽  
Symptomatic Gallstones ◽  
History Of ◽  
Gallstone Spillage ◽  
Saline Lavage

Abstract During laparoscopic cholecystectomy, gallbladder perforation may occur leading to gallstone spillage and despite being rare, early or late complications may therefore develop. We report a case of a 79-year-old female, with a past medical history of a laparoscopic cholecystectomy 3 years earlier for symptomatic gallstones, admitted in the emergency department with a subcutaneous right lumbar abscess confirmed by computed tomography. Emergent abscess surgical drainage was performed and a gallstone was identified during saline lavage. Postoperative evolution was unremarkable and follow-up within a year was uneventful. Split gallstones due to gallbladder perforation during laparoscopic cholecystectomy should be retrieved in order to reduce future complications.

scholarly journals Small Bowel Perforation due to Gossypiboma Caused Acute Abdomen

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Tahsin Colak ◽  
Tolga Olmez ◽  
Ozgur Turkmenoglu ◽  
Ahmet Dag
Keyword(s):  
Foreign Body ◽  
Small Bowel ◽  
Foreign Body Reaction ◽  
Acute Abdominal Pain ◽  
Surgical Complication ◽  
Bowel Perforation ◽  
Abdominal Cavity ◽  
Surgical Sponge ◽  
Palpable Mass ◽  
Retained Foreign Body

Gossypiboma, an infrequent surgical complication, is a mass lesion due to a retained surgical sponge surrounded by foreign body reaction. In this case report, we describe gossypiboma in the abdominal cavity which was detected 14 months after the hysterectomy due to acute abdominal pain. Gossypiboma was diagnosed by computed tomography (CT). The CT findings were a rounded mass with a dense central part and an enhancing wall. In explorative laparotomy, small bowel loops were seen to be perforated due to inflammation of long standing gossypiboma. Jejunal resection with end-to-end anastomosis was performed. The patient was discharged whithout complication. This case was presented to point to retained foreign body (RFB) complications and we believed that the possibility of a retained foreign body should be considered in the differential diagnosis of who had previous surgery and complained of pain, infection, or palpable mass.

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