Abstract
Gallstone spillage is recognised as a possible complication of laparoscopic cholecystectomy and there are countless examples of untoward short and long term sequelae resulting from their non-retrieval. We present the case of a 65-year-old gentleman with sterile pyuria and lower midline abdominal mass which proved to be a complex gallstone inflammatory mass related to the dome of the bladder. This patient's investigative course was exhaustive and the definitive diagnosis not achieved until histopathological assessment of the intraoperative specimen. The diagnosis of these lower abdominal wall masses can be difficult, particularly with complex lesions.