# Recurrent Acute Calculous Cholecystitis in a Retained Gallbladder Remnant: A Case Report

## TL;DR

A patient with a prior cholecystectomy developed recurrent gallbladder inflammation due to a retained gallbladder remnant, requiring a second surgery.

## Contribution

This case report highlights gallbladder remnant acute cholecystitis as a rare but important cause of RUQ pain after subtotal cholecystectomy.

## Key findings

- A retained gallbladder remnant can lead to recurrent acute calculous cholecystitis.
- Imaging and clinical history are crucial for diagnosing gallbladder remnant disease.
- Laparoscopic total cholecystectomy resolved the patient's symptoms.

## Abstract

We present the case of a 67-year-old woman with a history of prior laparoscopic cholecystectomy who presented with right upper quadrant (RUQ) pain and nausea and was found to have recurrent acute cholecystitis. Review of the operative note from her previous cholecystectomy revealed that a rim of gallbladder tissue had been left behind due to anatomical complications. CT of the abdomen and pelvis demonstrated a distended gallbladder with cholelithiasis, wall thickening, and pericholecystic fluid, consistent with acute calculous cholecystitis despite her history of prior cholecystectomy. The patient was admitted and later underwent definitive laparoscopic total cholecystectomy. Intraoperatively, extensive RUQ adhesions were taken down, the cystic duct was identified and clipped, and the gallbladder remnant was excised. This case highlights the importance of considering gallbladder remnant acute cholecystitis in patients with prior subtotal cholecystectomy who present with RUQ pain.