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    Back to the gallstone: a mischievous cause of morbidity.

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    URI
    http://hdl.handle.net/11287/613861
    Author
    Heron, Paul
    Manzelli, Antonio
    Date
    2016-06-17
    Journal
    BMJ case reports
    Type
    Case Report
    Publisher
    BMJ
    DOI
    10.1136/bcr-2013-202797
    Rights
    Archived with thanks to BMJ Case Reports
    Metadata
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    Abstract
    Laparoscopic cholecystectomies (LCs) are the gold standard treatment of symptomatic gallstone disease worldwide. However, with this technique comes the increased risk of retained spilled gallstones. We describe a case of a 77-year-old man who presented 2 months after undergoing a LC, with right upper quadrant pain. Abdominal ultrasound scan showed no significant complications, but he continued to have grumbling pains. These were investigated with an abdominal CT scan, prompting suspicion of a colorectal malignancy with pleural metastasis. However, on review by two different multidisciplinary teams, the final conclusion was probable residual gallstones with associated inflammation. This diagnosis was rather dramatically confirmed when the patient went on to expel gallstones percutaneously from his back and coughed out of his respiratory tract. This case highlights the importance of operative documentation of spilled gallstones, which can, in addition to more surprising consequences, mimic malignancy on investigation. This can lead to delay in correct management and cause undue patient distress.
    Citation
    Back to the gallstone: a mischievous cause of morbidity., 2016: BMJ Case Rep
    Publisher URL
    http://casereports.bmj.com/cgi/pmidlookup?view=long&pmid=27317757
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    RD&E staff have full-text access to BMJ Case Reports via NHS OpenAthens. Click on the 'Additional Link' above and log in with NHS OpenAthens if prompted.
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    • 2016 RD&E publications
    • Acute Medicine
    • Upper Gastro-Intestinal Surgery

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