ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Emergency surgical treatment of a ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment
Ümit Halıcı1, Volkan Yüksel2, Serhat Hüseyin2, Ahmet Okyay2, Suat Canbaz2, Hasan Sunar2
Trakya Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Edirne, Türkiye
1Samsun Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Samsun, Türkiye
2Trakya Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Edirne, Türkiye
DOI : 10.5606/tgkdc.dergisi.2014.9172
Background: This study aims to report the results of emergency operations of ruptured abdominal aortic aneurysm.

Methods: Between February 2001 and February 2011, 20 patients (1 female, 19 males; mean age 64.9±9.4 years; range 50 to 77 years) who were admitted to the emergency department and underwent emergency operation for ruptured abdominal aort aneurysm were retrospectively analyzed. Combined left thoracotomy + median laparotomy was performed in one patient (5%), while median laparotomy alone was performed in others. Aaortic cross clamping was applied following heparinization. In patients in whom aortic cross clamping was not suitable (n=3), proximal bleeding control was performed through occlusion by endoclamping with a Foley catheter. Aneurysmectomy + aortobifemoral bypass was performed in six patients (30%), aneurysmectomy + aortobiiliac bypass in 10 (50%), aneursymectomy + abdominal aortic graft interposition in two (10%), explorative laparotomy in one (5%), and thoracic + abdominal exploration in one (5%). Polytetrafluoroethylene (PTFE) pant graft (80%) and Dacron tube graft (10%) were used as graft materials during surgery.

Results: In the early postoperative period, ischemic colitis developed in one patient (5%), prolonged entubation (>72 hours) in four (20%), wound infection in one (5%), arrhythmia in two (10%), and disseminated intravascular coagulation in one (%5). The mean duration of intensive care unit and hospital stay were 3.8±2.1 days and 8.5±3.4 days, respectively. Total mortality was seen in four patients (20%).

Conclusion: We believe that early diagnosis of a ruptured abdominal aort aneurysm and endoclamping with a Foley catheter or an intraaortic balloon occlusion in patients who are ineligible for aortic cross clamping may increase the success of an emergency operation.

Keywords : Abdominal pain; emergency operation; ruptured abdominal aort aneurysm
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