Incidentally Detected Residual Gallbladder Calculi by Computed Tomography in Acute Pancreatitis. Case Report

Abstract

Calculi in the gallbladder or cystic duct remnant account for 0.3 to 2.5% of cases of post-cholecystectomy syndrome and must be considered in any patient who has undergone “difficult” cholecystectomy. We present an interesting case of a 62-year-old male, diagnosed to have moderately severe acute biliary pancreatitis, 4 years past laparoscopic converted to open cholecystectomy (LCOC). On evaluation with contrast computed tomography (CT) of the abdomen, changes of acute pancreatitis, along with a remnant gallbladder containing radiopaque calculi, were identified. The patient subsequently was managed successfully with completion cholecystectomy with common bile duct (CBD) exploration and T-tube drainage (for CBD calculi). Hence, differential diagnosis of residual gallbladder calculi (although rare) should be kept in a patient with acute biliary pancreatitis, following LCOC for a “difficult” gallbladder.