Hypersensitivity Reaction Post Laparoscopic Cholecystectomy Due to Retained Titanium Clips

Titanium is an inert metal that has many medical uses and applications because of its biocompatibility. However, titanium is not completely devoid of adverse reactions. This was the case of a 55-year-old female who presented following a laparoscopic cholecystectomy with right upper quadrant pain, diarrhea, nausea and eventual neuralgia in the right lower extremity. This led to a series of diagnostic procedures including an esophagogastroduodenoscopy (EGD), a colonoscopy, a CT scan, and an abdominal ultrasound, all of which proved to be futile. The patient was eventually formally diagnosed with hypersensitivity reaction due to titanium clips and underwent a diagnostic laparoscopy, adhesiolysis, and removal of foreign body under fluoroscopy. A total of four clips were identified and removed during the procedure. Repeat x-ray showed no evidence of further clips in the right upper quadrant nor throughout the abdomen. The patient was discharged the same day and showed improvement of symptoms one week later during the post-operative follow-up visit.