Granulomatous peritonitis after laparoscopic cholecystectomy mimicking pelvic endometriosis

Merchant SH, Shakil H. Merchant, S H Merchant, S Haghir, Haghir S, G B Gordon, Gordon GB
Obstetrics and gynecology · 2000 · vol. 96(5) , pp. 830–831 · doi:10.1016/s0029-7844(00)01049-8 · PMID:11094226 · W1994082649
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This case report details granulomatous peritonitis, mimicking pelvic endometriosis, which resulted from bile spillage during a previous laparoscopic cholecystectomy.

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Abstract

BACKGROUND: Spillage of bile or gallstones, a relatively common occurrence during laparoscopic cholecystectomy, is believed to be inconsequential, but we describe a case of postlaparoscopic granulomatous peritonitis mimicking endometriosis. CASE: A 20-year-old gravida 0 presented with chronic lower abdominal pain and dysmenorrhea. Laparoscopy showed red-brown pigmented pelvic adhesions, which on biopsy showed foreign-body-type granulomatous reaction, both suggesting endometriosis, but a history of laparoscopic cholecystectomy and a positive Fouchet's stain for bile gave the true etiology of the granulomatous reaction. CONCLUSION: With increasingly widespread use of laparoscopic cholecystectomy, and relatively common spillage of bile or gallstones at surgery, granulomatous peritonitis mimicking endometriosis might become more frequent.

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Condition tags

endometriosisdysmenorrhea

MeSH descriptors

Cholelithiasis Granuloma Peritonitis Adult Cholecystectomy, Laparoscopic Cholecystectomy, Laparoscopic Cholelithiasis Cholelithiasis Diagnosis, Differential Endometriosis Endometriosis Female Granuloma Granuloma Humans Peritonitis Peritonitis Peritonitis

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License: CC0 · commercial use OK