Open AccessGallbladder necrosis and small bowel ischaemia following fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysm: a case report
Author(s) -
A. Ng,
Michael Gale,
Bryce Renwick,
Paul Bachoo
Publication year - 2020
Publication title -
journal of surgical case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.14
H-Index - 3
ISSN - 2042-8812
DOI - 10.1093/jscr/rjaa046
Subject(s) - medicine , surgery , laparotomy , abdominal aortic aneurysm , aneurysm , gallbladder , endovascular aneurysm repair , superior mesenteric artery , inferior mesenteric artery , anastomosis , cholecystectomy , radiology , aortic aneurysm
Anatomical variation may result in unexpected complications after fenestrated endovascular aneurysm repair (FEVAR). We report a 78-year-old gentleman who was admitted for elective FEVAR procedure for a juxtarenal abdominal aortic aneurysm. Three days post-operatively, he deteriorated clinically. Computed tomography (CT) angiogram showed small bowel ischaemia and a replaced right hepatic artery originating from superior mesenteric artery. A necrotic gallbladder found during laparotomy required cholecystectomy following small bowel resection that required a relook for anastomosis and drainage of bile collection. He had prolonged ICU stay requiring treatment for multiple organ dysfunction then spent 4 weeks in hospital. Following multidisciplinary team approach in management of his complications during post-operative phase, he recovered well enough for rehabilitation and discharge home. Surveillance CT aorta at 1 month and 6 months post FEVAR showed satisfactory FEVAR appearance with no endoleak.