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The mucosal lining appeared grossly normal. The final pathology report came back chronic cholecystitis. The morning following surgery the patient was totally asymptomatic, saying “The spasms are gone”. The patient was doing well at the one week post-op visit. It is postulated that the serosanguinous peritoneal fluid was an incidental finding consistent with a ruptured hemorrhagic ovarian cyst (see massive hemorrhage from a ruptured hemorrhagic ovarian cyst and discussion). It is possible in view of the finding of a minor papilla that there was pancreatic divisum contributing to the biliary pathology, but there was no evidence of this condition on CT and ERCP was not indicated post operatively in view of the relief of symptoms and removal of the gallbladder. It is possible that the colon dilatation resulted from atony due to irritation of the peritoneal fluid. The dilated colon warrants observation for future functional problems (the patient reported some history of intermittent constipation) and the patient was warned about the possibility of volvulus with the large redundant sigmoid loop.
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