Intra-abdominal spilled gallstones simulating peritoneal metastasis: CT and MR imaging features (2008: 1b).

Laparoscopic cholecystectomy has rapidly become the preferred treatment for symptomatic cholecystolithiasis. However, the procedure is associated with a number of complications, one of which is the spillage of gallstones into the peritoneal cavity. Unretrieved gallstones may cause a wide variety of complications such as abscess, adhesion and small-bowel obstruction, or they may remain asymptomatic and harmless. In the latter case, spilled gallstones in the peritoneal spaces may cause diagnostic difficulty or mimic peritoneal metastasis. We present the computed tomography (CT) and magnetic resonance (MR) imaging features of intra-abdominal gallstone spillage in a case with head and neck neoplasm. Awareness of radiologic features of dropped intraperitoneal gallstones is necessary as they may be mistaken for peritoneal metastases.