Trinidad Bradley, Falconi Sirin, Kragh Nathan, Nazim Muhammad
Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, USA.
Department of Surgery, Northwest Texas Hospital, Amarillo, USA.
Cureus. 2023 Apr 11;15(4):e37433. doi: 10.7759/cureus.37433. eCollection 2023 Apr.
The incidence of symptomatic acute cholecystitis with large (greater than 5.5 cm) abdominal aortic aneurysm is an uncommon occurrence. Guidelines on concomitant repair in this setting remain elusive, particularly in the era of endovascular repair. We present a case of acute cholecystitis in a 79-year-old female presenting to a local rural emergency room with abdominal pain and known abdominal aortic aneurysm (AAA). Abdominal computed tomography (CT) revealed a 5.5 cm infrarenal abdominal aortic aneurysm, significantly greater in size compared to previous imaging, as well as a distended gallbladder with mild wall thickening and cholelithiasis concerning for acute cholecystitis. The two conditions were found to be unrelated to each other, but concerns were raised on appropriate timing of care. Following diagnosis, the patient underwent concomitant treatment of acute cholecystitis and large abdominal aortic aneurysm with laparoscopic and endovascular techniques, respectively. In this report, we take the opportunity to discuss the treatment of patients with AAA and concomitant symptomatic acute cholecystitis.
有症状的急性胆囊炎合并大（大于5.5厘米）腹主动脉瘤的发生率是一种罕见情况。关于这种情况下同时进行修复的指南仍然难以捉摸，尤其是在血管内修复时代。我们报告一例79岁女性，因腹痛就诊于当地农村急诊室，已知患有腹主动脉瘤（AAA），诊断为急性胆囊炎。腹部计算机断层扫描（CT）显示一个5.5厘米的肾下腹主动脉瘤，与之前的影像学检查相比尺寸明显增大，还有一个胆囊扩张、壁轻度增厚以及存在胆结石，提示急性胆囊炎。发现这两种情况彼此无关，但对恰当的治疗时机存在担忧。诊断后，患者分别通过腹腔镜和血管内技术同时接受了急性胆囊炎和大腹主动脉瘤的治疗。在本报告中，我们借此机会讨论AAA合并有症状急性胆囊炎患者的治疗。
