Emergent or Elective Operation for Symptomatic Abdominal Aortic Aneurysm

George Johnson Jr, MD; Noel B. McDevitt, MD; Herbert J. Proctor, MD; Stanley R. Mandel, MD; Jack B. Peacock, MD
Arch Surg. 1980;115(1):51-53. doi:10.1001/archsurg.1980.01380010043008.
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• The patient with the symptomatic abdominal aortic aneurysm (AAA) presents a management dilemma, ie, emergent, urgent, or elective operation. The mortality for 38 patients with a ruptured AAA prior to 1972 was 61%. That year, a policy of immediate operation was instituted for patients with symptoms that might be referable to a ruptured AAA. It is concluded that an immediate operation on the patient with a symptomatic but intact AAA resulted in an excessively high mortality. Thus, the indications for an immediate operation on these patients should be based on clinical judgment; attempting to differentiate between the patient with the ruptured and the patient with the intact aneurysm. Hemodynamic data (blood pressure or hematocrit reading) suggesting a decrease in blood volume dictate an immediate operation. An urgent operation on the well-prepared patient should be performed on all patients with a symptomatic aneurysm in which the clinical and hemodynamic findings do not suggest that it has ruptured.

(Arch Surg 115:51-53, 1980)


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