ABSTRACT
This work aims to provide a comprehensive description of the characteristics of a group of acute aortic diseases that are all potentially life-threatening and are collectively referred to as acute aortic syndromes (AASs). There have been recent developments in the care and diagnostic plan for AAS. A substantial clinical index of suspicion is required to identify AASs before irreversible fatal consequences arise because of their indefinite symptoms and physical indicators. A methodical approach to the diagnosis of AAS is addressed. Timely and suitable therapy should be started immediately after diagnosis. Improving clinical outcomes requires centralising patients with AAS in high-volume centres with high-volume surgeons. Consequently, the management of these patients benefits from the increased use of aortic centres, multidisciplinary teams and an "aorta code". Each acute aortic entity requires a different patient treatment strategy; these are outlined below. Finally, numerous preventive strategies for AAS are discussed. The keys to good results are early diagnosis, understanding the natural history of these disorders and, where necessary, prompt surgical intervention. It is important to keep in mind that chest pain does not necessarily correspond with coronary heart disease and to be alert to the possible existence of aortic diseases because once antiplatelet drugs are administered, a blocked coagulation system can complicate aortic surgery and affect prognosis. The management of AAS in "aortic centres" improves long-term outcomes and decreases mortality rates.
ABSTRACT
BACKGROUND: Gallbladder perforation with gallstone spillage during laparoscopic cholecystectomy is usually an event with no consequences. CASE REPORT: We report the case of a 66 year-old female admitted in our hospital with severe large abscess in the right lumbar region. Her medical history reveals a laparoscopic cholecystectomy for acute gallstone cholecystitis. Emergent abscess incision and drainage are performed, noticing a mass of stone outline. The abdominal CT scan shows fluid, air-bubbled collection with biloculate walls located in the right retroperitoneal subhepatic region. Laparoscopic procedure is performed, the subhepatic abscess is located and drained, the abscess cavity containing 19 gallstones. OUTCOME: The post-operative evolution was favourable. The patient was discharged on the 6th post-operative day. CONCLUSIONS: The stones left in the peritoneal cavity during laparoscopic cholecystectomy may be sometimes the cause of severe late complications.
