A case of empyema following subphrenic abscess caused by residual gallstones after laparoscopic cholecystectomy
Nana Akazawaa,* Hiroshi Moriokab Yuki Yamashitaa Tsutomu Sakuraia Kazuto Takadaa Eiji Kojimaa
aDivision of Respiratory and Allergy Medicine, Komaki Municipal Hospital
bDepartment of Infectious Diseases, Nagoya University Hospital
*Present address: Division of Infectious Diseases, Shizuoka Cancer Center Hospital
We herein report an 81-year-old man with a history of laparoscopic cholecystectomy (LC) for cholelithiasis four years ago who visited our emergency room due to right upper quadrant pain. Unenhanced computed tomography showed a subphrenic abscess with a rounded calcified nodule and a small amount of right pleural effusion. On the fifth day of admission, chest radiograph revealed a massive right pleural effusion. After pleural drainage, he was diagnosed with empyema following subphrenic abscess caused by residual gallstones. Both laparotomy and thoracotomy were performed on him in addition to the administration of antibiotics. Subphrenic abscess following residual gallstones is notorious as one of the serious complications after LC, and rarely causes empyema. Sharing information about the potential risk of residual gallstones with surgeons and patients is important for early diagnosis and intervention.
Laparoscopic cholecystectomy (LC) Residual gallstone Dropped gallstone Empyema Subphrenic abscess
Received 18 Jan 2019 / Accepted 11 Mar 2019
AJRS, 8(4): 235-239, 2019