Acute acalculous cholecystitis complicating abdominal aortic aneurysm resection

Area of Science:

• Vascular Surgery
• Gastroenterology
• Surgical Complications

Background:

• Postoperative complications following abdominal aortic aneurysm (AAA) repair require vigilant monitoring.
• Acute acalculous cholecystitis is a rare but serious complication that can arise after major vascular surgery.
• Men with comorbidities undergoing AAA repair, especially for ruptured aneurysms, may be at increased risk.

Purpose of the Study:

• To report on the incidence and characteristics of acute acalculous cholecystitis in patients recovering from abdominal aortic aneurysm repair.
• To highlight the clinical presentation, diagnostic methods, and treatment outcomes for this specific patient group.
• To emphasize the importance of early diagnosis and intervention for suspected cholecystitis post-AAA repair.

Main Methods:

• Retrospective case review of six patients who developed acute acalculous cholecystitis after AAA repair.
• Analysis of patient demographics, medical history, surgical details, and postoperative course.
• Review of diagnostic modalities (ultrasound, hepatobiliary scan) and therapeutic interventions (cholecystostomy, cholecystectomy).

Main Results:

• Six male patients developed acute acalculous cholecystitis at a mean of 3 weeks post-AAA repair.
• Common symptoms included right upper quadrant pain, fever, leukocytosis, and elevated liver function tests.
• Mortality rate was 50%, with three patients treated with cholecystostomy and three with cholecystectomy.

Conclusions:

• Acute acalculous cholecystitis is a significant risk following abdominal aortic aneurysm repair.
• Prompt diagnosis using imaging (ultrasound, hepatobiliary scan) is essential.
• Early surgical management (cholecystostomy or cholecystectomy) is recommended for patients not improving with conservative treatment.