Ruptured abdominal aortic aneurysms carry a high mortality rate (42.5%) and a high incidence of complications, predominantly acute renal failure and shock.
High mortality and renal complications persist in ruptured AAA; leaves open optimal preventive and perioperative strategies.
A study of 80 patients with ruptured aortic aneurysms admitted over an eight-year period to the Intensive Care Unit of the authors' hospital was undertaken. All the information was introduced to a data base and processed for statistical treatment by use of a software program. Most patients admitted to the emergency room presented diffuse or localized abdominal pain. An abdominal mass was present in 40% of the cases. Hypotension was usually present with shock in 20% of the patients. The diagnosis was confirmed essen tially by computerized axial tomography. In 27% of the patients, operation was under taken based on clinical grounds only. Sixty-seven percent of the patients showed one or more complications. Acute renal failure (51%), sepsis (31%), acute respiratory insuffi ciency (20%), mesenteric ischemia (13%), coagulopathy (11%), and neurologic compli cations (11%) were the most often encountered. The mortality rate was 42.5%; shock was the most common cause of death, and mesenteric ischemia was the second.
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Masclans et al. (1994) studied this question.
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