Dropped gallstone-induced perihepatic abscess mimicking malignancy: the diagnostic value of multimodality imaging

Authors : Umur Anıl Pehlivan, Elif Karadeli

Pages : 1193-1195

Doi:10.17826/cumj.1796926

View : 74 | Download : 167

Publication Date : 2025-12-22

Article Type : Other Papers

Abstract :Dropped gallstones following laparoscopic cholecystectomy are a recognized complication that may lead to the development of late-onset intra-abdominal abscesses. These collections often present with nonspecific clinical features and can mimic malignant processes, posing considerable diagnostic challenges. A 49-year-old male was evaluated for a four-month history of cough, hemoptysis, and night sweats that developed after undergoing laparoscopic cholecystectomy. An initial computed tomography (CT) scan raised suspicion for a neoplastic process. Subsequent multimodality imaging—including positron emission tomography-computed tomography (PET-CT), magnetic resonance imaging (MRI), and repeat contrast-enhanced CT—demonstrated a perihepatic-subdiaphragmatic abscess containing internal dense foci, suggestive of dropped gallstones. The diagnosis was confirmed during surgical exploration and subsequent histopathological analysis. This case underscores the importance of including spilled gallstones among key differential diagnoses in patients who develop late-onset subdiaphragmatic collections following laparoscopic cholecystectomy. Recognition of characteristic imaging features—such as intralesional hyperdense foci on CT, internal hypointense nodules on MRI, central diffusion restriction, specific metabolic patterns on PET-CT, and other supportive MRI findings—is essential to prevent misdiagnosis and guide appropriate clinical management.
Keywords : Kolesistektomi, Safra Kesesi Taşları, Subfrenik Apse, Tanısal Görüntüleme

ORIGINAL ARTICLE URL