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Ruptured aneurysms of the abdominal aorta.

The experience with ruptured aneurysms of the abdominal aorta is reported. Out of 395 aneurysms observed, 78 were ruptured. A review of case histories and an analysis of the causes of death demonstrate the importance of prompt diagnosis and early operation: delay and the use of complicated (TC) or invasive (angiography) instrumental examinations does not appear justified since clinical symptoms, plain standard abdominal films and ultrasound almost always lead to prompt diagnosis. Notwithstanding the improvements in resuscitation and intensive care procedures, a significant difference persists between the mortality rate of elective surgery (3 to 8%) and that of emergency surgery. There were 28 deaths (36%) for emergency surgery as against 3.4% for operations performed for non-ruptured aneurysms. This confirms the need for preventive treatment of aneurysmal lesions of the abdominal aorta, since even aneurysms smaller than 5 cm may rupture.