[Emergency aneurysm of the abdominal aorta in a general surgery department]

We reviewed 26 consecutive patients from 1.1.81 to 30.6.89, 21 males and 5 females, mean age 72 (+/- 6.7) years, range 51-81, admitted and operated on for ruptured (19 cases) or leaked (7) abdominal aortic aneurysm in a general surgery unit at the University of Parma. Since we deal mainly with gastroenterologic and oncologic surgery, emergency operations were 70.2% of the overall series of aortic aneurysms, and were carried out over an actual 776 day period of emergency admission service. Nineteen patients had shock, ten being already anuric. Ultrasounds were carried out in nineteen cases, with an accuracy of 91.6% for ruptured and 57.1% for leaking aneurysms. Mortality rate, 50% was significantly related to the number of perioperative blood transfusions and anuria, which express the degree of shock and blood loss. Operative results were similar to other major series. A successful approach and management of aortic ruptured aneurysm is an uncommon challenge even in non-specialized surgical units. A vascular surgical training is therefore necessary for general surgeons.