Clinical Analysis of Abdominal Aortic Aneurysm

ABSTRACT

PURPOSE: In patients with small or large aneurysms, the decision for surgical treatment is not so simple. The mortality of ruptured abdominal aortic aneurysm (AAA) is high. This study was designed to retrospectively analyse the clinical characteristics of patients with AAA. METHODS: Ninety-one cases of AAA were surgically treated between January 1991 and January 2003 at the Department of Surgery, Chonnam National University Hospital. Patients were divided into 49 elective cases and 42 emergency cases, and retrospective analysed on the basis of age, sex, chief complaints, physical examination, associated diseases, size of aneurysm, diagnostic modalities, operative mortality and causes of death. RESULTS: The initial presentations were mainly palpable masses in the elective cases. On the other hand, in the emergency cases which were ruptured, many patients complained of abdominal or back pain. There was a positive relationship between the size of AAA and the incidence of the rupture in our study, especially in the case of transverse diameters above 10 cm (P<0.001). There was no death in the elective cases, but there were 22 surgical mortalities in the 42 emergency cases (52.3%, P<0.001). Overall surgical mortality was 24.1%. The causes of death were intraoperative and postoperative bleeding (11), myocardial infarction (5), acute renal failure (4), and sepsis (2). CONCLUSION: Surgical mortality in ruptured AAA was high. Consequently, surgical intervention is recommended and the operation must be performed. In that way we can reduce the operative mortality and improve the treatment outcome.