Abstract
The surgical results of 19 patients with ruptured abdominal aortic aneurysm experienced in a recent 6-year period were compared with those of elective patients, and factors affecting the mortality rate were discussed. Their ages ranged from 57 to 86 years with a mean of 67.5. There were 17 men and 2 women. Eleven patients (57.9%) were in shock. Diagnosis were made only through clinical symptoms in 2 patients, and through the findings of abdominal CT in 17. Two patients suffered from cardiac arrest before or during operation and died before graft replacement. A bifurcated Dacron graft was implanted in 16 patients and axillobifemoral bypass was performed in one. There were 5 operative deaths (26.3%) within 30 days after surgery. The additional two patients; one with mycotic aneurysm ruptured into the duodenum and the other with a complication of MNMS, died on 34th and 72nd day after surgery, respectively. The hospital mortality rate was 36.8%. These mortality rates were significantly higher than those of elective patients (0.8%: p<0.0001, 3.3%: p<0.005). The main cause of the 5 operative deaths was circulatory instability and coagulopathy due to acute massive bleeding. Hence the mortality rate would decrease with some limitation, if immediate proximal control and the treatment for coagulopathy are established.
