Iatrogenic Lesions of Biliary Tract Caused by Foreign Body: A Case Report

Objective: Case report of biliary tract lesion caused by the presence of a foreign body into the abdominal cavity after cholecystectomy. Case report: A 56-year-old woman reported postprandial fullness, nausea, vomiting, hyperexia, weight loss, pain and palpable mass in right hypochondrium for 15 months, three months after she had been submitted to cholecystectomy due to chronic calculous cholecystitis. She also reported the onset of jaundice and itching in the last 40 days. On physical examination the patient was icteric (2+/4+), dehydrated (1+/4+), arterial pressure of 180x120mmHg, tense and painful abdomen at deep palpation on the right hypochondrium without signs of peritoneal irritation. The abdominal ultrasound and abdominal computed tomography depicted dilation of intrahepatic biliary tract and injury of the hepatic ducts junction. Meeting synthesis: The patient was submitted to laparoscopy where it was observed severe inflammatory process over the main biliary tract and a foreign body on the light of the choledochous. Choledoctomy was performed with the withdrawal of the foreign body and reconstruction through choledochoplasty of the choledochohepatic tube over the Kehr drain. Discussion: Biliary tract lesion due to a foreign body is a rare complication with an increased morbid-mortality rate associated with difficulty to obtain an early diagnosis and surgical correction1.