Dropped gallstones mimicking intraabdominal implants or tumor: A report of two cases

INTRODUCTION AND IMPORTANCE: Dropped gallstones are an uncommon complication of laparoscopic cholecystectomy. Few reports have described dropped gallstones that were found accidently. Here, we encountered two cases of dropped gallstones that were unexpectedly found during surgery. CASE PRESENTATION: Case 1 involved a 54-year-old woman who has undergone a total abdominal hysterectomy with bilateral salpingo-oophorectomy for endometrioid cancer in the right ovary which was confirmed by histology. During surgery, a small firm nodule was seen in the omentum. An omentectomy is done for histological evaluation. Case 2 involved a 29-year-old woman admitted for an elective Caesarean section. During surgery, a firm nodule in the vesicouterine pouch was found. The nodule was carefully removed and sent to the pathology department. Microscopically, both cases revealed a fibrous wall enclosing gallstone associated with a foreign body-type granulomatous reaction. CLINICAL DISCUSSION: Dropped gallstones (DGs), also referred to as spilled gallstones, into the peritoneal cavity are an uncommon complication of laparoscopic cholecystectomy. Clinically spilled gallstones usually remain silent for months or years after laparoscopic cholecystectomy and can be found during imaging or surgery. CONCLUSION: Clinicians should keep in mind that mass-forming lesions within the peritoneal cavity, due to dropped gallstones, may mimic neoplasia.