S H Merchant1, S Haghir, G B Gordon. 1. Department of Pathology, State University of New York, Upstate Medical University, Syracuse, New York, USA.
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.
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.
Authors: Hasong Jeong; Hye Won Lee; Hye Ra Jung; Ilseon Hwang; Sun Young Kwon; Yu Na Kang; Sang Pyo Kim; Misun Choe Journal: J Pathol Transl Med Date: 2018-07-16