title: Ischemic gall bladder perforation: a complication of type A aortic dissection.
abstract: Malperfusion of end organs occurs in 20% to 40% patients with acute type A aortic dissection. Because irreversible ischemia is a time-dependent event, expedient diagnosis and treatment are necessary. We herein report successful surgical management of a patient with acute type A aortic dissection causing transient gut ischemia and a rare gall bladder perforation. We implemented one-stage surgical and laparoscopic management approach for the diagnosis and treatment. Increased awareness of this complication and appropriate use of available diagnostic tools may improve the outcome in similar patients. Patients with aortic dissection complicated by visceral ischemia require a prompt sequential and rational multidisciplinary approach for successful management.
authors.affiliation: Division of Adult Cardiac Surgery, Sheikh Khalifa Medical City (managed by Cleveland Clinic), Abu Dhabi, United Arab Emirates. nk_jha@hotmail.com
authors.forename: Neerod K
authors.initials: NK
authors.lastname: Jha
authors.forename: Rajappan A
authors.initials: RA
authors.lastname: Kumar
authors.forename: Moataz
authors.initials: M
authors.lastname: Ayman
authors.forename: Javed A
authors.initials: JA
authors.lastname: Khan
authors.forename: Massimo
authors.initials: M
authors.lastname: Cristaldi
authors.forename: Charles
authors.initials: C
authors.lastname: Ahene
authors.forename: Norbert
authors.initials: N
authors.lastname: Augustin
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000792:Angiography / Q000379:methods; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D005500:Follow-Up Studies; D005704:Gallbladder / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008382:Marfan Syndrome / Q000150:complications* / Q000175:diagnosis; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome