BRONCHOLITHIASIS AND THORACOABDOMINAL ACTINOMYCOSIS FROM DROPPED GALLSTONES

We report a case of successfully managed invasive, thoracoabdominal ac tinomycosis caused by the intraperitoneal spillage of gallstones durin g laparoscopic cholecystectomy. The infected gallstones traversed the diaphragm, migrated into the lung parenchyma, and obstructed a segment al bronchus, causing pneumonia. Treatment involved retrieval of the ob structing stone, debridement and drainage of the pleuroperitoneal phle gmon/abscess, and intravenous antibiotics. The case illustrates the ne ed to remove gallstones at the time of cholecystectomy. (C) 1998 by th e Society of Thoracic Surgeons.