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Start Over Author "Sterpetti, Antonio V." Journal journal of vascular surgery
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13. Sealed rupture of abdominal aortic aneurysms

Author

Sterpetti, Antonio V., Blair, Elizabeth A., Schultz, Richard D., Feldhaus, Richard J., Cisternino, Silvestro, and Chasan, Paul

Subjects
Abdominal aneurysm, Aortic aneurysms -- Complications, Health
Abstract

The diagnosis of a ruptured abdominal aortic aneurysm (tearing of the localized area of dilated aortic wall) is easily made on the basis of abdominal or back pain, shock and a pulsating mass in the abdomen. A chronic sealed rupture of an abdominal aortic aneurysm, an unusual condition in which the aneurysm ruptures but is contained, is difficult to diagnose. However, if left untreated, a sealed rupture may re-open, causing massive hemorrhage. Sixteen patients with chronic sealed rupture of an abdominal aortic aneurysm were evaluated. The study group included 15 men and 1 woman with an average age of 72. Two patients had symptoms of acute aneurysm rupture and were treated surgically; in addition to the hemorrhaging aneurysm, a sealed rupture was also found. One patient died. The remaining patients were treated surgically with good results and remission of their symptoms. A rupture can seal itself off if there is slow bleeding and a high degree of resistance from the surrounding tissue. Although hypertension is considered to be a risk factor for rupture of an aneurysm, normal blood pressure may increase the risk of the rupture sealing. A small perforation is also more easily contained. The mechanism of sealing in small aneurysms appears to involve an aortic wall that is still quite strong, and a limited tear. The site of the tear in the aortic aneurysm was most often (10 patients) posterior and adjacent to the vertebrae; the bleeding was most likely walled off by the bony structure. In elderly patients who complain of unexplained back or inguinal (groin) pain, the diagnosis of sealed rupture of an abdominal aneurysm should be considered. Computed tomography is helpful in making the diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

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