Spilled gallstones with surrounding inflammation

Abstract

A 62-year-old Turkish man was referred for ultrasonography of a palpable mass in the left upper abdomen. Past medical history revealed emergency laparoscopic cholecystectomy for acute calculus cholecystitis about 6 months earlier in Turkey. On clinical examination there was a small palpable mass with mild tenderness in the left subcostal region. Due to a language barrier it was uncertain if the swelling was present before or after the cholecystectomy. Ultrasonography revealed a calcified lesion. The differential diagnosis at that time was dystrophic calcifications or a soft tissue tumor with calcification. However, additional conventional imaging of the left subcostal region revealed no calcifications. In the work-up of a possible soft tissue tumor MRI was performed.