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Infected aortic pseudoaneurysm following laparoscopic cholecystectomy
1Department of Vascular Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298, USA. mmlevy@hsc.vcu.edu
Annals of Vascular Surgery
|August 30, 2001
Summary
A rare aortic pseudoaneurysm complication occurred after laparoscopic cholecystectomy in a hemodialysis patient. Surgical repair resolved the infection and bacteremia, highlighting potential vascular risks of the procedure.
Area of Science:
- Vascular Surgery
- Gastrointestinal Surgery
- Infectious Disease
Background:
- Laparoscopic cholecystectomy is a common procedure for gallstones.
- Vascular complications are rare but serious sequelae of laparoscopic surgery.
- Hemodialysis patients may have increased risk factors for complications.
Observation:
- A 38-year-old hemodialysis-dependent diabetic female presented with chronic back pain post-laparoscopic cholecystectomy.
- Eight months later, she developed fevers and recurrent bacteremia with methicillin-resistant Staphylococcus aureus.
- Imaging revealed a 7-cm aortic pseudoaneurysm originating from the abdominal aorta.
Findings:
- The patient underwent resection of the infected aortic pseudoaneurysm and extraanatomic bypass.
- Post-operatively, her bacteremia resolved, and she recovered.
- This is the first reported case of an aortic pseudoaneurysm following laparoscopic cholecystectomy.
Implications:
- Laparoscopic cholecystectomy, while generally safe, can rarely lead to significant vascular complications.
- Aortic pseudoaneurysms are a potential, albeit infrequent, complication that requires prompt diagnosis and surgical intervention.
- Awareness of these rare vascular risks is crucial for surgeons performing laparoscopic procedures, especially in high-risk patient populations.