THROMBOSIS OF ABDOMINAL AORTIC-ANEURYSMS

The usual complication of abdominal aortic aneurysms is rupture. Altho ugh thrombosis of peripheral aneurysms is common, thrombosis of abdomi nal aortic aneurysms is rare. Sudden thrombosis of abdominal aortic an eurysms constitutes a surgical emergency, with a mortality of 50 perce nt. The patient often presents with cool and mottled skin, and with se vere pain from the umbilicus to the lower extremities. Femoral pulses are rarely present, and neurologic deficits below the level of occlusi on are common. We reviewed four recent patients with thrombosed abdomi nal aortic aneurysms. They presented with a range of symptoms that inc luded impotence, abdominal pain, lower extremity pain, coolness, and w eakness. Angiography in three of the patients revealed complete occlus ion of the aorta. The fourth patient did not undergo angiography becau se of hemodynamic instability. Three of the four patients underwent th rombectomy, aneurysmectomy, and bypass grafting. The other patient und erwent axillofermoral bypass grafting in lieu of aneurysmectomy becaus e of severe coronary arteriosclerotic heart disease. All patients did well postoperatively. Our limited experience suggests that prompt diag nosis and surgical management of patients with thrombosed aortic aneur ysms can lead to a successful outcome.