EMERGENCY MEDICAL-MANAGEMENT OF RUPTURED DISSECTING AORTIC-ANEURYSMS - DIAGNOSIS AND THERAPEUTIC STRATEGIES

Between December 1991 and January 1994 fifteen patients with a rupture d abdominal aortic aneurysm and seven patients with a dissecting aorti c aneurysm were treated in our emergency department. Dissection/ruptur e of an aortic aneurysm is still a dramatic event with poor outcome, w hereby survival depends largely on early diagnosis. In most cases the diagnosis can be made with reasonable assurance by history taking and physical examination. The most frequent differential diagnoses are pul monary embolism and myocardial infarction (thoracic aneurysms) and ren al or biliary colic and lumbago (abdominal aneurysms). The largest del ay in commencing therapy is caused by patients' hesitation to call the Emergency Medical Service. Chest X-ray, echocardiography and abdomina l sonography are of high diagnostic value, computed tomography confirm s the diagnosis in most cases. Our Emergency Department provides the f acilities for rapid diagnosis and interdisciplinary preoperative manag ement of dissecting/ruptured aortic aneurysms.