University Journal of Surgery and Surgical Specialities
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Ruptured Abdominal Aortic Aneurysm - a case series from a tertiary care hospital in South India.
Abstract
BACKGROUND-Ruptured abdominal
aortic aneurysms (AAA) are a dramatic
life threatening emergency. Ruptured
AAAs can be repaired by open or endovascular
method. However, 4 to 5 of
sudden deaths in the west are attributed
to undiagnosed ruptured AAA. METHODS-
We report the clinical features and
the outcome of patients presenting with
ruptured AAA who underwent open repair
at a tertiary care centre in South India.
A retrospective analysis of inpatients
and outpatient records from January
2010 to July 2011 was done. Diagnosis
of ruptured abdominal aortic aneurysm or
impending rupture was made on clinical
grounds and confirmed with an abdominal
ultrasound or computed tomographic
scan. RESULTS -Five patients presented
with ruptured AAA from January 2010 to
July 2011. There were four males and
one female patient. The mean age at
presentation was 57 years.
All the patients presented with abdominal
pain and a pulsatile abdominal mass (n5),
one patient presented with shock. Computed
tomographic scan, ultrasound or angiogram
showed aneurysm involving infra
renal abdominal aorta (n3), supra renal abdominal
aorta (n1) and juxtarenal abdominal
aorta (n1). The mean diameter of the
aneurysm was 8.7 cm. The mean intraoperative
blood loss was 1700 ml. The
mean duration of stay in ICU was 11 days
and the mean hospital stay was 23 days.
There was one patient who needed a reexploration
due to renal graft thrombosis.
The outcome was favorable in four patients.
One patient was discharged moribund.
CONCLUSION - Early diagnosis, aggressive
resuscitation and early surgical
intervention is essential in the treatment for
ruptured aortic aneurysm. A triad of abdominal
pain hypotension and a pulsatile
mass is pathognomic for diagnosis of ruptured
AAA. Morbidity and mortality rates of
open surgical repair
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