The development of abscesses from dropped stones is probably related to the significant bacterial content gallstones. It has been shown that bacteria also have an adhesive property that facilitates pigment stone formation. This correlates with the finding that most abscesses due to dropped stones are found in association with calcified stones. Another explanation may be that infected bile causes these abscesses. The diagnosis is often made by CT imaging. Acalcified nidus is often identified within the abscess. If the stone is not calcified, the etiology of the abscess may be initially unclear.
this is radiology images of “Dropped stone” after cholecystectomy:
radiology images of “Dropped stone” after cholecystectomy. Coned-down view of the pelvis reveals a calcific density due to a dropped stone postcholecystectomy. (Courtesy of R. Wachsberg, M. D., Newark, NJ)
“radiology images of “Dropped stones” after cholecystectomy.” (A) CT scan of the upper abdomen demonstrates calcific densities due to calculi in the perihepatic space with associated small amount of fluid. (B) Another patient with similar findings. (C) CT scan of the upper abdomen in another patient with multiple calculi and fluid in the right subhepatic space. (D) Sonogram in a fourth patient demonstrating fluid and a calculus in the pelvis.
radiology images of “Dropped stones” migrating into the pleural space with empyema.