PROSPECTIVE-STUDY ON FACTORS DELAYING SURGERY IN RUPTURED ABDOMINAL AORTIC-ANEURYSMS

Delays between rupture, eventual diagnosis and the repair of abdominal aortic aneurysms (AAAs) can significantly affect outcome, but the rea sons for such delays in management are not always dear. A prospective study was, therefore, performed on 30 patients with ruptured AAAs. Twe nty-three male and seven female patients, mean age 71.3 years, were st udied. The general practitioner had made the correct diagnosis in only 38% of cases and the most common misdiagnosis was renal colic (24%). Non-vascular hospital doctors made the correct diagnosis in 55% of cas es, but patients with back pain were the most frequently misdiagnosed by both types of doctor. The performance of an ultrasound scan signifi cantly delayed referral to the vascular unit from a median of 0.75 to 2.50 hours and was of little benefit in aiding the diagnosis. In concl usion, the most striking delay factors in the management of ruptured A AAs are the high incidence of misdiagnosis and the lack of benefit of ultrasound scanning.