RESUMO
Dropped gallstones are a common complication during a laparoscopic cholecystectomy. The formation of an abdominal abscess related to the dropped gallstones is rare because the majority of these calculi do not cause complications. Ultrasound is a usually used first-line imaging modality to detect gallstones in the abscess. CT scan may be used to confirm the diagnosis of abscess and for topographic analysis. We report the case of a lady presented to the emergency department 2 months after laparoscopic cholecystectomy; for acute cholecystitis; with acute abdomen and fever. Laboratory values revealed an elevated white blood cell count (WBC) and C-reactive protein concentration (CRP). The diagnosis of intra-abdominal abscess was evoked by ultrasound and contrast-enhanced CT, and confirmed by laparoscopy. The purpose of this paper is to illustrate the importance of searching and recognizing dropped gallstone within collection, particularly in the context of previous laparoscopic cholecystectomy.
RESUMO
Rectovesical fistulas are rare and typically result from inflammatory or neoplastic conditions in the small pelvis. They occur within a pelvic region that has been altered by local inflammatory or neoplastic processes. This explains the challenges in detecting these fistulas using conventional imaging techniques, despite the effectiveness of CT and MRI. Colonic diverticulosis is the primary cause of colovesical fistulas. To date, there have been no reported cases of a rectovesical fistula associated with a bladder diverticulum in the literature. We present a case of a patient who presented with a large stone within a bladder diverticulum. The migration of this stone into the rectum revealed an advanced rectal tumor. The unique aspect of our case is primarily the presence of a rectovesical fistula arising from a lateral bladder diverticulum. Additionally, we observed the migration of the diverticular calculus from the bladder to the rectum.