Lost and found: expectoration of a retained gallstone years after cholecystectomy

In a previous report published in this journal,1 we described the case of a 64-year-old male who presented with a positron emission tomography(PET)-positive lung lesion that was ultimately attributed to extensive peridiaphragmatic inflammation surrounding lost gallstones following a prior laparoscopic cholecystectomy. At that time, the patient underwent a right thoracotomy. Intraoperatively, the lung was found to be firmly adherent to the diaphragm, making dissection technically challenging. A diaphragmatic defect caused by erosion was identified, through which the abdominal cavity was explored. No gallstones were visualised or palpated. Given these findings and in the absence of infectious or malignant features, a lobectomy was not performed and the surgical team elected to leave the gallstones in situ and primarily close the diaphragmatic defect. During follow-up, serial CT scans demonstrated stable findings without any evidence of stone migration.