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Ann Thorac Surg 2001;72:280
© 2001 The Society of Thoracic Surgeons

Case report: invited commentary

Invited commentary

Paul D. Kiernan, MDa, Jeffrey Anderson, MDa, Samir Fakhry, MDa a Department of Surgery, Sections of Thoracic Surgery and Trauma Services, Inova Fairfax Hospital, 3300 Gallows Rd, Falls Church, VA 22042-3300, USA

The undersigned read with interest Drs Werber and Wright’s case report that describes "a subhepatic abscess erroding through the diaphragm causing a pulmonary abscess and resulting in massive hemoptysis from gallstones." We agree with the authors’ conclusions concerning the risks that spilled gallstones present, as well as their operative strategy and management.

We comment to highlight that although spilled gallstones may be a rare cause of lung abscess, subdiaphragmatic abscesses are not. We recently encountered a very similar case presentation, arising from a subdiaphragmatic abscess complicating blunt hepatic trauma, with no associated thoracic trauma. Successful resolution ensued, using the same operative strategy that Drs Werber and Wright advised.


Related Article

Massive hemoptysis from a lung abscess due to retained gallstones
Yaron B. Werber and Cameron D. Wright
Ann. Thorac. Surg. 2001 72: 278-279. [Abstract] [Full Text] [PDF]




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