Abdominal Wall Abscess Secondary to Spilled Gallstones 20 Years after Laparoscopic Cholecystectomy

This case report describes an intra-abdominal and abdominal wall abscess formation in a 53-year male. The abscess developed 20 years after an uncomplicated laparoscopic cholecystectomy. He presented to multiple clinics with complaints of abdominal swelling and pain and had been prescribed multiple courses of antibiotics in the preceding six months before a definitive diagnosis was made. Subsequent ultrasound and computed tomography scans confirmed intra-abdominal abscess infiltrating the liver and the abdominal wall abscess. Incision and drainage were performed and multiple gallstones in the abscess cavity were visualised. Early postoperative complications including abscess formation usually come to attention; however, the importance of late complications should not be undervalued, especially when an abscess develops in a patient with a history of recent or remote cholecystectomy. Thorough investigation, consideration of possible diagnosis related to abscess formation post-cholecystectomy, and timely action is the key to management. Key Words: Abdominal wall abscess, Laparoscopic cholecystectomy, Complications, Retained gallstones.This case report describes an intra-abdominal and abdominal wall abscess formation in a 53-year male. The abscess developed 20 years after an uncomplicated laparoscopic cholecystectomy. He presented to multiple clinics with complaints of abdominal swelling and pain and had been prescribed multiple courses of antibiotics in the preceding six months before a definitive diagnosis was made. Subsequent ultrasound and computed tomography scans confirmed intra-abdominal abscess infiltrating the liver and the abdominal wall abscess. Incision and drainage were performed and multiple gallstones in the abscess cavity were visualised. Early postoperative complications including abscess formation usually come to attention; however, the importance of late complications should not be undervalued, especially when an abscess develops in a patient with a history of recent or remote cholecystectomy. Thorough investigation, consideration of possible diagnosis related to abscess formation post-cholecystectomy, and timely action is the key to management. Key Words: Abdominal wall abscess, Laparoscopic cholecystectomy, Complications, Retained gallstones.