AORTIC BLISTERS - DIAGNOSIS AND EVOLUTION

In order to evaluate the incidence, the diagnostic modalities and sign ificance of blisters of the abdominal aortic aneurysm wall, in a retro spective review, 14 patients (2.6%) having these lesions were identifi ed between 1983 and 1995, At preoperative examination, aortography had less accuracy (1 case=20%) than CT scan (3 cases=27.2%) or MRI angiog raphy (6 cases=85.7%) to detect blisters; others were discovered intra operatively in the remaining four patients, Most blisters were located on the anterior or antero-lateral wall of aneurysms; its area ranged from 0.8 to 2.6 cm(2), One patient with a suspected blister diagnosed at aortography, during chest physiotherapy for his COPD, presented sud den abdominal pain: at urgent laparotomy, an acute contained rupture o f a large blister; without extraluminal blood loss, was found, All pat ients underwent aneurysm repair, with no postoperative deaths, Occurre nce of rupture in one patient clearly indicates the natural course of aortic blisters, MRI angiography may accurately detect these lesions; surgical treatment is necessary for preventing imminent rupture.