Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute lung injury as a remote sequela of severe lower torso ischemia-reperfusion has been demonstrated experimentally, in a process involving leukosequestration and generation of the arachidonate derivatives thromboxane and leukotriene B4. However, contemporary clinical reports have been limited to development of transient, subclinical "reperfusion pulmonary edema" several hours after declamping in patients undergoing elective abdominal aortic aneurysm repair. This report refocuses attention on the clinical syndrome of severe, acute deterioration in pulmonary function occurring several hours after restoration of perfusion to an ischemic lower torso in two patients. The lung injury is characterized by progressive hypoxemia, pulmonary hypertension, decreased lung compliance, and non-hydrostatic pulmonary edema, consistent with adult respiratory distress syndrome (ARDS). This report reinforces the concept that humoral mediators generated at reflow may induce end-organ injury at a site remote from the focus of ischemia-reperfusion, and that the lung is a target organ.
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PMID:Pulmonary failure following lower torso ischemia: clinical evidence for a remote effect of reperfusion injury. 789 94

Toxic oxygen free radical damage is thought to play an important role in events such as trauma and sepsis, in which adult respiratory distress syndrome (ARDS) and multiple organ failure (MOF) are the major causes of late death. Serum lipofuscin concentration has been proposed as an indicator of lipid peroxidation caused by toxic oxygen free radicals. Serum lipofuscin level was measured in 75 healthy controls and sequentially in 66 patients in the intensive care unit; the latter included 18 patients who had undergone elective major vascular surgery, 20 after repair of ruptured abdominal aortic aneurysm and 28 with severe blunt trauma. Fifteen of the 66 patients died within 2 days. Ten of the remaining 51 patients developed ARDS and/or MOF and 41 had an uncomplicated postoperative course. Serum lipofuscin concentration in controls showed a positive correlation with age. Compared with controls, all three patient groups had significantly increased lipofuscin concentrations during the first day after major vascular surgery, trauma or shock. In addition, the ten patients who subsequently developed ARDS and/or MOF showed significantly increased lipofuscin levels on day 1, compared with those in the 41 who had an uncomplicated clinical course. The concentration of serum lipofuscin, which may act as a simple and valuable measure of grading oxidative stress, is positively related to the incidence of subsequent ARDS and/or MOF in patients at risk of these syndromes.
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PMID:Serum lipofuscin as a prognostic indicator of adult respiratory distress syndrome and multiple organ failure. 795 92

The outcome of ruptured abdominal aortic aneurysm repair was reviewed in 83 consecutive patients with special emphasis on the influence of subsequent laparotomy. The overall 30-day mortality was 47%. Causes of death were exsanguination in six, cardiac failure in 15, uncontrolled hypotension in six, multiple organ failure (MOF) in nine, adult respiratory distress syndrome in one and sepsis in two patients. Thirty-three relaparotomies were performed in 21 patients after a mean interval of 10 days. Suspected intraabdominal haemorrhage was the indication in 15 and sepsis in 18 cases. The preoperative diagnosis proved to be correct in 12/15 (80%) and 11/18 (61%) instances, respectively. Negative explorations were mainly performed in patients with an established MOF syndrome. Relaparotomies were associated with a significantly (p < 0.05) increased mortality of 76%. The complications that give rise to the need for surgical reintervention are usually accompanied by a clinical deterioration of the patient and inevitably reduce the chances of survival. However, until a reliable predictor of mortality is developed, treatment should not be denied in individual cases.
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PMID:Relaparotomies after ruptured abdominal aortic aneurysm repair. 801 86

We describe herein the case of a patient with severe liver failure in whom an abdominal aortic aneurysm (AAA) extending to the right iliac artery was diagnosed. Because the risk of performing a standard open repair was considered too high in this patient, the aneurysm was uneventfully repaired using a technique of transfemoral endovascular stent-grafting with femorofemoral bypass and occlusion of the left common and right internal iliac arteries. Unfortunately, multiorgan failure associated with adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) suddenly developed on postoperative day (POD) 2 and the patient died on POD 9. Thus, although endovascular stent-grafting is generally assumed to be less invasive and therefore feasible for high-risk patients, patients with severe liver dysfunction may not be suitable candidates.
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PMID:Adverse outcome following transfemoral endovascular stent-graft repair of an abdominal aortic aneurysm in a patient with severe liver dysfunction: report of a case. 1095 46