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Bleeding peptic ulcer after abdominal aortic aneurysm surgery.

H Konno1, S Sakaguchi, T Hachiya

  • 1Second Department of Surgery, Hamamatsu University School of Medicine, Japan.

Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1991
PubMed
Summary

Patients with abdominal aortic aneurysm (AAA) have a higher incidence of gastroduodenal ulcers and coagulopathy. Proactive treatment of these conditions before vascular reconstruction can prevent postoperative bleeding.

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Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Hematology

Background:

  • Gastroduodenal ulcers are a concern in patients undergoing vascular surgery.
  • Abdominal aortic aneurysm (AAA) and arteriosclerosis obliterans (ASO) share risk factors but may differ in associated complications.
  • Coagulopathy and altered gastric mucosal parameters are potential contributors to gastrointestinal bleeding.

Purpose of the Study:

  • To investigate the prevalence of gastroduodenal lesions in patients with AAA and ASO.
  • To assess the risk of postoperative bleeding in these patient groups.
  • To explore the relationship between coagulopathy, gastric mucosal changes, and bleeding complications.

Main Methods:

  • Retrospective analysis of 112 AAA patients and 232 ASO patients.

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  • Prospective evaluation of 48 AAA patients and 30 ASO patients.
  • Endoscopic examination, assessment of serum fibrinogen, platelet counts, and gastric mucosal parameters.

    • Main Results:

    • 16.7% of AAA patients and 1.6% of ASO patients had a history of gastroduodenal ulcers.
    • 52.1% of AAA patients and 20.0% of ASO patients showed pre-existing gastroduodenal lesions.
    • Lower serum fibrinogen and platelet counts were observed in AAA patients; proactive treatment prevented postoperative bleeding.

    Conclusions:

    • Patients with AAA exhibit a higher prevalence of gastroduodenal lesions and coagulopathy compared to ASO patients.
    • Preoperative identification and management of gastroduodenal lesions and coagulopathy are crucial for preventing postoperative bleeding in AAA patients.
    • Reduced gastric mucosal blood flow and prostaglandin content in AAA patients may contribute to ulcer formation.