World Journal of Medical and Surgical Case Reports Volume No 8

Case Report Open Access

Osteomyelitis as a rare complication of laparoscopic cholecystectomy: a case report

Hakkenbrak Nadia, Boogerd Noor, Moes Daan and de Brauw Maurits
World Journal of Medical and Surgical Case Reports 2019, 8:3

Abstract

Introduction 

Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures worldwide. A small percentage of patients revisit the hospital or outpatient clinic with post-operative complications such as infection, bleeding, biliaryor bowel injury. In this case report, we describe a very rare complication.

Case presentation

A 71-year-old male presented at our outpatient clinic with abdominal pain and fatigue. The patient had been admitted abroad, two months before,with biliary pancreatitis and cholangitis due to choledocholithiasis for which laparoscopic cholecystectomy wasperformed. However, the abdominal pain increased. Additional imagingshowed intra-abdominal abscesses. After one month of treatment the patient visited the emergency room with a painful swelling of the right lower thoracic cavity. Follow up CT-scan showed reduction of the sub-hepatic abscess but swelling surrounding the 11thrib suggestive of osteomyelitis. Therefore, thepatient was operated and the rib was partially resected. Intravenous antibiotics were continued based on tissue cultures.

Conclusion

An intra- abdominal abscess is a rare complication after laparoscopic cholecystectomy (<1%). Spillage of stones or bile increase the risk of abdominal abscesses. In this case report the sub-hepaticabscess migrated towards the rib resulting in osteomyelitis. Given the therapeutic difficulty of osteomyelitis, aggressive treatment is necessary to prevent this complication and limit further harm.

Keywords

bile stones, bile spillage, postoperativecomplication.




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