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Gastric outlet obstruction by a lost gallstone: Case report and literature review

INTRODUCTION: Spilled gallstones from a laparoscopic cholecystectomy can be a source of significant morbidity, most commonly causing abscesses and fistulae. Preventative measures for loss, careful removal during the initial surgery, and good documentation of any concern for remaining intraperitoneal...

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Autores principales: Koichopolos, Jennifer, Hamidi, Moska, Cecchini, Matthew, Leslie, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655411/
https://www.ncbi.nlm.nih.gov/pubmed/29073549
http://dx.doi.org/10.1016/j.ijscr.2017.10.014
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author Koichopolos, Jennifer
Hamidi, Moska
Cecchini, Matthew
Leslie, Kenneth
author_facet Koichopolos, Jennifer
Hamidi, Moska
Cecchini, Matthew
Leslie, Kenneth
author_sort Koichopolos, Jennifer
collection PubMed
description INTRODUCTION: Spilled gallstones from a laparoscopic cholecystectomy can be a source of significant morbidity, most commonly causing abscesses and fistulae. Preventative measures for loss, careful removal during the initial surgery, and good documentation of any concern for remaining intraperitoneal stones needs to be performed with the initial surgery. CASE REPORT: An 80-year-old male with a history of complicated biliary disease resulting in a cholecystectomy presented to general surgery clinic with increasing symptoms of gastric outlet obstruction. CT imaging was concerning for a malignant process despite negative biopsies. A distal gastrectomy and Billroth II reconstruction was performed and final pathology showed dense inflammation with a single calcified stone incarcerated within the gastric wall of the inflamed pylorus and no malignancy. DISCUSSION: Stones lost during laparoscopic cholecystectomy are not innocuous and preventative measures for loss, careful removal during the initial surgery, and good documentation of any concern for remaining intraperitoneal stones. CONCLUSION: This is the first case of gastric outlet obstruction caused by an intramural obstruction of the pylorus from a spilled gallstone during a laparoscopic cholecystectomy and subsequent inflammation. This is an etiology that must be considered in new cases of gastric outlet obstruction and can mimic malignancy.
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spelling pubmed-56554112017-10-30 Gastric outlet obstruction by a lost gallstone: Case report and literature review Koichopolos, Jennifer Hamidi, Moska Cecchini, Matthew Leslie, Kenneth Int J Surg Case Rep Article INTRODUCTION: Spilled gallstones from a laparoscopic cholecystectomy can be a source of significant morbidity, most commonly causing abscesses and fistulae. Preventative measures for loss, careful removal during the initial surgery, and good documentation of any concern for remaining intraperitoneal stones needs to be performed with the initial surgery. CASE REPORT: An 80-year-old male with a history of complicated biliary disease resulting in a cholecystectomy presented to general surgery clinic with increasing symptoms of gastric outlet obstruction. CT imaging was concerning for a malignant process despite negative biopsies. A distal gastrectomy and Billroth II reconstruction was performed and final pathology showed dense inflammation with a single calcified stone incarcerated within the gastric wall of the inflamed pylorus and no malignancy. DISCUSSION: Stones lost during laparoscopic cholecystectomy are not innocuous and preventative measures for loss, careful removal during the initial surgery, and good documentation of any concern for remaining intraperitoneal stones. CONCLUSION: This is the first case of gastric outlet obstruction caused by an intramural obstruction of the pylorus from a spilled gallstone during a laparoscopic cholecystectomy and subsequent inflammation. This is an etiology that must be considered in new cases of gastric outlet obstruction and can mimic malignancy. Elsevier 2017-10-17 /pmc/articles/PMC5655411/ /pubmed/29073549 http://dx.doi.org/10.1016/j.ijscr.2017.10.014 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Koichopolos, Jennifer
Hamidi, Moska
Cecchini, Matthew
Leslie, Kenneth
Gastric outlet obstruction by a lost gallstone: Case report and literature review
title Gastric outlet obstruction by a lost gallstone: Case report and literature review
title_full Gastric outlet obstruction by a lost gallstone: Case report and literature review
title_fullStr Gastric outlet obstruction by a lost gallstone: Case report and literature review
title_full_unstemmed Gastric outlet obstruction by a lost gallstone: Case report and literature review
title_short Gastric outlet obstruction by a lost gallstone: Case report and literature review
title_sort gastric outlet obstruction by a lost gallstone: case report and literature review
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655411/
https://www.ncbi.nlm.nih.gov/pubmed/29073549
http://dx.doi.org/10.1016/j.ijscr.2017.10.014
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