Laparoscopic management of intra-abdominal fish bone mimicking acute cholecystitis
Epublication WebSurg.com, Nov 2011;11(11). URL: http://websurg.com/doi/vd01en3427
This video shows a female patient of 62 years, presenting with acute upper abdominal pain with fever and vomiting for five days. Clinically, she presented with features of acute cholecystitis. Blood examination revealed leukocytosis with normal liver function tests. Abdominal ultrasonography showed edema of the gallbladder wall with pericholecystic collection, cholelithiasis and signs of acute cholecystitis. Under antibiotic cover, the patient was subjected for single-port laparoscopic cholecystectomy using the EK glove port. Due to dense and stubborn adhesions, the procedure was converted to conventional 3-port surgery. The duodenum was found adherent to the infundibulum of the gallbladder with a fish bone and pus within it. A 3.3cm long fish bone perforated the duodenum, produced abscess and mimicked acute cholecystitis. The fish bone was extracted, perforation was repaired and cholecystectomy was performed.