Abstract
Between 1960 and 1979 528 patients with abdominal aortic aneurysms presented to the university department of surgery. Of these, 222 (42%) were elective cases, 72 acute (14%), 174 had ruptured (33%), and four had had a spontaneous aortoduodenal fistula (1%). In all these patients resections were undertaken, but in another 56 patients (11%) the aneurysm was not resected. A review of these cases showed that 91% had symptoms at their first presentation; abdominal pain and backache being most common. The diagnosis could be established in 91% by the presence of pulsatile abdominal mass on clinical examination. The operative mortality for elective resection was 8%, for acute 19%, for ruptured cases 42%, and for spontaneous aortoduodenal fistula 50%. After successful resection the overall five-year survival was 65% by the life table method, and there was no significant difference between elective, acute, and ruptured cases. This five-year survival after resection compares favourably with the expected 76% survival of a similar normal population, and was considerably better than that for conservatively treated patients. As most cases have symptoms, and diagnosis may be established easily by routine physical examination in 91%, the prognosis for this condition could be considerably improved by increased awareness of its existence and early referral for treatment as an elective surgical procedure.
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Selected References
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- Bergan J. J., Yao J. S. Modern management of abdominal aortic aneurysms. Surg Clin North Am. 1974 Feb;54(1):175–193. doi: 10.1016/s0039-6109(16)40243-4. [DOI] [PubMed] [Google Scholar]
- Bernstein E. F., Dilley R. B., Goldberger L. E., Gosink B. B., Leopold G. R. Growth rates of small abdominal aortic aneurysms. Surgery. 1976 Dec;80(6):765–773. [PubMed] [Google Scholar]
- DEBAKEY M. E., CRAWFORD E. S., COOLEY D. A., MORRIS G. C., Jr, ROYSTER T. S., ABBOTT W. P. ANEURYSM OF ABDOMINAL AORTA ANALYSIS OF RESULTS OF GRAFT REPLACEMENT THERAPY ONE TO ELEVEN YEARS AFTER OPERATION. Ann Surg. 1964 Oct;160:622–639. doi: 10.1097/00000658-196410000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ESTES J. E., Jr Abdominal aortic aneurysm; a study of one hundred and two cases. Circulation. 1950 Aug;2(2):258–264. doi: 10.1161/01.cir.2.2.258. [DOI] [PubMed] [Google Scholar]
- Gordon-Smith I. C., Taylor E. W., Nicolaides A. N., Golcman L., Kenyon J. R., Eastcott H. H. Management of abdominal aortic aneurysm. Br J Surg. 1978 Dec;65(12):834–838. doi: 10.1002/bjs.1800651203. [DOI] [PubMed] [Google Scholar]
- MANTEL N., HAENSZEL W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959 Apr;22(4):719–748. [PubMed] [Google Scholar]
- McGregor J. C. Unoperated ruptured abdominal aortic aneurysms: a retrospective clinicopathological study over a 10-year period. Br J Surg. 1976 Feb;63(2):113–116. doi: 10.1002/bjs.1800630206. [DOI] [PubMed] [Google Scholar]
- Szilagyi D. E., Smith R. F., DeRusso F. J., Elliott J. P., Sherrin F. W. Contribution of abdominal aortic aneurysmectomy to prolongation of life. Ann Surg. 1966 Oct;164(4):678–699. doi: 10.1097/00000658-196610000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turk K. A. The post-mortem incidence of abdominal aortic aneurysm. Proc R Soc Med. 1965 Nov;58(11 Pt 1):869–870. doi: 10.1177/003591576505811P109. [DOI] [PMC free article] [PubMed] [Google Scholar]