Gallbladder perforation during laparoscopic cholecystectomy with spillage of bile and gallstones occurs in a substantial percentage of patients (up to 40%). We report the case of a 77-year-old woman who presented with fever of unknown etiology and a complication of retroperitoneal abscess mimicking a gluteal abscess with gallstones and clips the abscess. Spillage of gallstones from perforation of the gallbladder is a well-recognized complication of laparascopic cholecystectomy, especially several months after the initial surgery, as in the reported case.
Purpose: Interventional techniques are rapidly supplanting conventional surgical therapies for the treatment of brachiocephalic occlusive disease. Although coronary-subclavian steal has been successfully alleviated with subclavian angioplasty, we report the first use of a Palmaz stent in the left subclavian artery (SCA) of a patient with a compromised left internal mammary artery (IMA) graft. Methods and Results: A 65-year-old male patient had undergone triple coronary artery bypass grafting in 1992, but 6 months later, severe narrowing occurred in two of the saphenous vein grafts, and arteriography identified a high-grade stenosis in the SCA supplying the left IMA graft to the left anterior descending coronary artery. Following balloon dilation of one saphenous vein graft stenosis, the left SCA was stented primarily with a P3008 Palmaz stent. Normal hemodynamics were restored, and the patient has been free of coronary steal symptoms for over 1 year. Conclusion: This case illustrates yet another aspect to the usefulness of intravascular stents in restoring and maintaining in flow to bypass grafts.
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