Intra-abdominal and abdominal wall haematoma from 5 mm port insertion site in laparoscopic cholecystectomy

Trocar insertion is an essential and initial part in any laparoscopic procedure. Inadvertent abdominal wall vascularinjury, leading to intra-abdominal bleeding or abdominal wall haematoma due to trocar insertion, may occur at thisfirst step. We report here a case of uneventful laparoscopic cholecystectomy in a 44-year-old woman, which was followedlater by large abdominal wall haematoma through the 5 mm trocar insertion site. Emergency laparotomy wasneeded to control the bleeding. Delayed abdominal wall haematoma can occur even with most lateral, 5 mm trocarinsertions. Learning abdominal wall vascular anatomy, transilluminating the abdominal wall before trocar insertionand entering the abdominal cavity at a right angle may decrease the possibility of this complication.