Intraperitoneal spilled gallstones presenting as fever of unknown origin after laparoscopic cholecystectomy: FDG PET/CT findings

An otherwise healthy 63-year-old man who had undergone emergency laparoscopic cholecystectomy for acute calculous cholecystitis 6 weeks earlier developed daily fever for more than 3 weeks, malaise, weight loss, and elevated erythrocyte sedimentation rate. Initial imaging procedures (abdominal ultrasound and chest radiograph) were normal. The diagnosis of fever of unknown origin was established, and a whole-body FDG PET/CT scan was performed. PET/CT showed inflammatory changes corresponding to spilled intraperitoneal gallstones. We have described the PET/CT findings of spilled intraperitoneal gallstones, a relatively common complication of laparoscopic cholecystectomy.