Retroperitoneal rupture of abdominal aortic aneurysms

Objective. About 40 % of patients with ruptured abdominal aortic aneurysm ( AAA) die before admission to the hospital. The next 40-50 % of patients who reach a hospital die in the perioperative period or within 30 days after s urgery. Two groups of patients with ruptured AAA can be distinguished: firs t - with intra-abdominal rupture, second - with retro-peritoneal rupture. T he aim of the study was a retrospective analysis of the treatment results i n patients with retro-peritoneal rupture of AAA. Material and methods. 78 patients underwent a surgical procedure between 1. 01.1985 and 30.10.1996. 78 patients (68 men and 10 women). mean age 67.6 (5 3-94) were included in this study. Based on diagnostic and surgical procedu res, two periods of treatment can be distinguished. In the first period of the time from 1.01.1985 to 31.12.1992 patients were operated on immediately after admission to the hospital. In the second period from 1.01.1993 to 31 .10.1996 patients were admitted to Intensive Care Unit. in this unit patien ts were intensively treated and prepared for surgical procedure. During thi s time the computerized tomography scanning (CT) was performed. Results. In the first period the perioperative mortality was 75 %. In the s econd period the perioperative mortality was 41.3 %. Discussion. The 1.5-2 hours postponement of operative procedure of the pati ents with retro-peritoneal rupture of AAA can decrease perioperative mortal ity. During the time patients were intensively treated and prepared for sur gical procedure and CT examination enabled to choose proper surgical techni que.