A case of right subphrenic granuloma caused by spilled gallstones after laparoscopic cholecystectomy

Abstract

The patient was an 80-year-old woman who underwent laparoscopic cholecystectomy for acute cholecystitis. She visited another hospital with a chief complaint of right back pain and was referred to our department with a suspected liver abscess. Contrast-enhanced computed tomography revealed irregular thickening with contrast enhancement on the dorsal side of the right lobe of the liver and a cystic structure with calcification. The lesion extended to the liver, right kidney, and 10th and 11th ribs. Considering the possibility of a malignant retroperitoneal tumor, we proposed needle biopsy. However, the patient strongly requested early surgery; therefore, we decided to proceed with the surgery. Intraoperatively, the mass had invaded the 11th rib, diaphragm, right kidney, and liver; thus, retroperitoneal tumor resection was performed along with partial resection. The resected specimen contained a gallstone. Histopathological examination revealed granuloma. The patient was diagnosed with granuloma caused by spilled gallstones after laparoscopic cholecystectomy. Here, we report a rare case of granuloma formation due to spilled gallstones after laparoscopic cholecystectomy.