Gallbladder necrosis and small bowel ischaemia following fenestrated endovascular aneurysm repair for juxtarenal abdominal aortic aneurysm: a case report.

Abstract

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.

• Authors: Alvin Yuan Liang Ng, Michael Gale, Bryce Renwick, Paul Bachoo
• Journal: Journal of surgical case reports (J Surg Case Rep) Vol. 2020 Issue 3 Pg. rjaa046 (Mar 2020) ISSN: 2042-8812 [Print] England
• PMID: 32226602 (Publication Type: Case Reports)
• Copyright: Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.