Abstract
Post-cholecystectomy syndrome is a group of disorders resulting from complications of laparoscopic cholecystectomy. Here we report a case of a 59-year-old female patient with history of cholecystectomy who presented with right hypochondrium pain and bloating. Ultrasound and magnetic resonance cholangiopancreatogram revealed a tubular cystic lesion with calculus in situ in the gallbladder fossa in keeping with cystic duct remnant.
Highlights
CASE REPORT A 59-year-old female patient presented with abdominal pain and bloating sensation after every meal
Careful surgery, sticking to the basics helps in reducing possibility of cystic duct remnant leading to Post-cholecystectomy syndrome (PCS)
Careful evaluation is needed to rule out all non-biliary causes before pin-pointing the cause for PCS
Summary
CASE REPORT A 59-year-old female patient presented with abdominal pain and bloating sensation after every meal. Ultrasound examination of abdomen done elsewhere revealed cystic lesion in the right hypochondrium in the gall bladder bed. On MRCP (Figure 1), there is an oblong cystic lesion seen in the gall bladder fossa. This cystic lesion is showing a focal T2* shortening which is interpreted as a remnant stone (Figures 2,3). The lesion is not connecting with the common biliary duct (CBD) Both the CBD and intrahepatic biliary radicles are otherwise unremarkable. The MRCP is interpreted as remnant cystic duct with a calculus in situ. Based on the above findings, the patient was subjected to laparoscopic exploration and the residual cystic duct with calculus were successfully removed. The patient improved dramatically with alleviation of cholestatic symptoms and follow-up ultrasound abdomen every 6 months was unremarkable
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