A case of giant lesser sac abscess caused by perforated cholecystitis

Abstract

A 76-year-old man was emergently seen at the hospital because of upper abdominal pain and fever. Abdominal CT scan showed a low density mass measuring 14 cm in maximum diameater in the peritoneal cavity. It was located immediately dorsal to the stomach and hepatic left lobe, ventral to the pancreas. It was located in the lesser sac anatomically. We diagnosed it as a lesser sac abscess and performed an emergency laparotomy. We felt a solid mass dorsal to the stomach and lesser omentum, and the gallbladder was forming a cholecystoduodenal fistula. We performed incisional drainage and cholecystectomy. He has been in good health without recurrence of lesser sac abscess for 7 months postoperatively.
Lesser sac abscess needs an early drainage of intraperitoneal abscess, because it sametimes causes severe complications. We experienced a case of giant lesser sac abscess caused by perforated cholecystitis.