Abdominal aortic aneurysm and gastrointestinal disease: should synchronous surgery be considered?

BACKGROUND: Abdominal aortic aneurysm (AAA) is relatively common in an age group in which other abdominal pathologies have an increasing incidence. The co-existence of an aneurysm with a second intra-abdominal pathology presents a difficult management problem for the surgeon. Synchronous aortic and gastrointestinal surgery is often avoided due to the perceived higher risk of infection of the vascular prosthesis. METHODS: Cases of synchronous AAA repair with a second gastrointestinal/biliary procedure were identified from the operative records of a single vascular surgeon working in a district general hospital. RESULTS: Eight cases were identified over a 10-year period, comprising 3 large bowel resections, 2 cholecystectomies and 3 upper gastrointestinal operations as the second synchronous procedure. No graft infections were recorded in this group and there was one death within 30 days. CONCLUSIONS: From our experience and a review of the available literature we conclude that synchronous aortic and gastrointestinal surgery should be considered when urgent surgery for both conditions is indicated.