Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms

R. James Valentine, Mary Jane Barth, Stuart I. Myers, G. Patrick Clagett

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background. Patients may present with signs and symptoms of ruptured abdominal aortic aneurysm (RAA) but actually have other diseases mimicking RAA. The outcome of these patients has not been reported. Methods. During the past 10 years, 16 patients presumed to have RAAs were found at operation to have other diseases accounting for the symptoms. Fifteen patients (94%) had abdominal pain, 9 (56%) had a pulsatile abdominal mass, and 7 (44%) were hypotensive on presentation. Results. Ten of the 16 patients had intact aortic aneurysms at surgery; there were no reliable physical signs or diagnostic tests that could discern between RAAs and intact aneurysms with other intraabdominal diseases. Eight patients (50%) died in the perioperative period, including four with widespread metastases, three with overwhelming sepsis, and one with an acute myocardial infarction. None of the 10 patients with aneurysms suffered RAA after emergency laparotomy. Exploratory laparotomy was necessary to treat underlying disease in nine patients and was probably harmful only to the patient with a myocardial infarction. Two survivors with aneurysms underwent successful staged repairs. Conclusions. Mistaken diagnoses in patients who are suspected of having RAAs on the basis of physical findings are relatively uncommon. Exploratory laparotomies are required to correct the primary disease in most of these misdiagnosed patients. Few die as a direct result of laparotomy; true iatrogenic catastrophes associated with mistaken diagnoses are distinctly uncommon.

Original languageEnglish (US)
Pages (from-to)286-289
Number of pages4
JournalSurgery
Volume113
Issue number3
StatePublished - 1993

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Aortic Rupture
Abdominal Aortic Aneurysm
Emergencies
Laparotomy
Aneurysm
Myocardial Infarction
Perioperative Period
Aortic Aneurysm
Diagnostic Errors
Routine Diagnostic Tests
Abdominal Pain
Signs and Symptoms
Survivors
Sepsis

ASJC Scopus subject areas

  • Surgery

Cite this

Valentine, R. J., Barth, M. J., Myers, S. I., & Clagett, G. P. (1993). Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms. Surgery, 113(3), 286-289.

Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms. / Valentine, R. James; Barth, Mary Jane; Myers, Stuart I.; Clagett, G. Patrick.

In: Surgery, Vol. 113, No. 3, 1993, p. 286-289.

Research output: Contribution to journalArticle

Valentine, RJ, Barth, MJ, Myers, SI & Clagett, GP 1993, 'Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms', Surgery, vol. 113, no. 3, pp. 286-289.
Valentine RJ, Barth MJ, Myers SI, Clagett GP. Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms. Surgery. 1993;113(3):286-289.
Valentine, R. James ; Barth, Mary Jane ; Myers, Stuart I. ; Clagett, G. Patrick. / Nonvascular emergencies presenting as ruptured abdominal aortic aneurysms. In: Surgery. 1993 ; Vol. 113, No. 3. pp. 286-289.
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