Abdominal Aortic Aneurysms, Cholesterol Gallstones, and the "Einstein Sign"

Abstract

Between January, 1981, and De cember, 1986, 386 patients under went an elective abdominal aortic aneurysmorrhaphy of which 18 pa tients had a concomitant cholecystec tomy (6 other patients had had a cholecystectomy for biliary colic pre viously). The 24 patients (20 male and 4 female) had an average age of seventy-two years. All patients had cholesterol gallstones, and no patient had cholecystitis. There were no post operative complications and no mor tality attributable to having performed the combined procedures. The operative time was increased by only eighteen minutes and the length of hospital stay was not prolonged. Two patients with known cholelithia sis and abdominal aortic aneurysm presented with right-sided abdominal pain (Einstein sign), and emergency CT scans demonstrated retroperito neal hemorrhage. Cholecystectomy was not performed when a ruptured aneurysm was repaired. It is recom mended that concomitant cholecys tectomy and abdominal aortic aneurysmorrhaphy be performed if there are no mitigating circumstances in elective cases but that cholecystec tomy not be combined with repair of a ruptured aneurysm.