Dropped gallstones eroding into the abdominal wall

Discussion:

Gangrenous cholecystitis complicated by spilled gallstones, postoperative abscess formation and drainage, and more delayed presentation of right flank mass containing fluid/stones eroding through the right lateral abdominal wall. 

This case highlights the inflammatory nature of dropped gallstones and how they can result in delayed complications, and the importance of reviewing previous imaging in order to piece the story together. 

Dropped gallstones result from perforation of the gallbladder during cholecystectomy. While often they do not cause any patient harm, they can result in abscess or fistula formation after weeks, months, or even years 1.

This patient was managed with incision and drainage, with a note of several small foreign bodies resembling fragmented gallstones. 

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