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Query: UMLS:C0162871 (abdominal aortic aneurysm)
 8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spontaneous aortoenteric fistulas are rare but appear to be increasing. They may occur anywhere from the esophagus to the rectum but most often between the duodenum and an infrarenal abdominal aortic aneurysm. Four patients (two with aortoesophageal, one with aortoduodenal, and one with aortocolic fistulas) are presented. The patient usually presents with the clinical triad of aortic aneurysm, pain suggesting aortic disruption, and gastrointestinal hemorrhage. The final exsanguinating hemorrhage is usually preceded by prodomal hemorrhages of varying severity which may be present for weeks to months. Endsocopy is the most helpful diagnostic procedure. Prompt aggressive surgical therapy is the only hope for survival. Successful reconstruction requires placement of the graft in uninfected tissue--often in an extraanatomic position--and interposition of healthy tissues between the graft and the repaired enteric tract.
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PMID:Diagnosis and management of spontaneous aortoenteric fistulas. 30 26

O2 and CO2 tensions were measured in the gastrocnemius muscles of patients submitted for reconstructive arterial surgery due to obstructive arteriosclerosis (37) or abdominal aortic aneurysm (5). Four patients without signs of arterial ischaemia served as controls. Measurements were carried out by means of implanted silastic tonometers during breathing of air and 100% O2 and immediately after walking on a treadmill. Peripheral blood pressures in the ankles were recorded with a Doppler apparatus. Baseline tissue gas tensions showed no essential differences between the various groups of patients: intermittent claudication, pain at rest, praegangrene, abdominal aortic aneurysm and controls. In contrast, baseline ankle pressures correlated well with the severity of the disease. During breathing of oxygen, the smallest increases of muscle PO2 were observed in extremities with pain at rest or praegangrene and the highest responses were recorded in controls and aneurysm patients. Muscle PCO2 values showed no alterations during oxygen breathing. In physical exercise, muscle PO2 and PCO2 levels as well as ankle blood pressures remained unchanged in controls and patients with aneurysm but no claudication. However, in all groups with arterial ischaemia, the exercise test resulted in a profound fall of muscle PO2 and ankle blood pressure and an increase of muscle PCO2.
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PMID:Tissue gas tensions in the calf muscles of patients with lower limb arterial ischaemia. 43 76

Aortoduodenal fistula may occur primarily as a complication of abdominal aortic aneurysm or secondarily after reconstructive surgery of the abdominal aorta. The clinical presentation may be occult, with the classic triad of mass, pain, and bleeding inapparent or overshadowed by signs of infection. A high index of clinical suspicion combined with radiographic and endoscopic examinations will establish the diagnosis.
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PMID:A complicated case of aortoduodenal fistula. 51 Aug 80

A patient with an abdominal aortic aneurysm with a preaortic left renal vein fistula is presented. Review of the 7 reported cases of aorto-left renal vein fistulae demonstrates many similarities in the clinical presentation with aorto-caval fisulae. However, in addition to the triad of pain, pulsatile abdominal mass and bruit, commonly found in aorto-caval fistulae, the presence of hematuria, proteinuria, and azotemia suggests a renal vein fistula. Radiographic studies often demonstrate a large non-functional left kidney. Operative management of the fistula may be performed by a variety of maneuvers. All 7 patients survived. When repair was undertaken without delay, function in the left kidney returned to normal within two months postoperatively.
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PMID:Aorto-left renal vein fistula: an unusual complication of abdominal aortic aneurysm. 93 15

Fifty-six patients with a ruptured abdominal aortic aneurysm presented to an acute general hospital over six years from 1968 to 1973. Twelve patients died before operation, while 19 of 44 patients (43%) survived replacement of the aneurysm with a Dacron graft. Patients aged under 70 years and not shocked on admission to hospital had the best chance of survival. It is suggested that survival rates can be significantly raised only by a decrease in the time between the onset of symptoms and an operation. A correct diagnosis may be made more often if it is remembered that the classical clinical triad of pain, shock and an abdominal mass is seen is less than half of the cases presenting to hospital.
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PMID:Ruptured abdominal aortic aneurysms presenting to a general hospital. 114 44

The subject of spontaneous aortocaval fistula due to a ruptured abdominal aortic aneurysm into the inferior vena cava is reviewed and discussed. An interesting case is presented with particular emphasis on the pre-operative findings which include lower body cyanosis; pain, numbness, and paralysis of the lower extremities; a cyanotic partial penile erection; and moderate shock. The cause of this syndrome is postulated.
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PMID:The large spontaneous aorta inferior vena caval fistula. 122 66

A case of an uncommon variant of aortic aneurysm, inflammatory type, is reported. A 51-year-old Thai male presented with a pulsatile abdominal mass associated with pain. Ultrasonography demonstrated infrarenal abdominal aortic aneurysm preoperatively and operative findings revealed dense fibrous tissue around the lesion. Serological tests for syphilis and bacteriological studies of aneurysm contents were all negative. Aneurysmorrhaphy was done, using Dacron straight graft, and two serious complications developed at six and two months interval: aortocolonic and aortoduodenal fistulae. However, the patient survived the three operations. Definite diagnosis of inflammatory aortic aneurysm was confirmed by typical pathological findings. Clinical presentations, operative and pathological findings were compared to previous literature.
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PMID:Inflammatory aortic aneurysm: a case report and review of literatures. 130 24

It has been found that the effects of tooth extraction under acupuncture anesthesia (AA) for the old patients are generally quite good. In order to verify this result, the authors had statistically analysed 825 cases aged over 60 years (Group A) and equal quantity whose age were between 18-40 years old (Group B) out of more than 4000 cases whose records of AA were rather completely during 1973 to 1988. 1. There was no significant difference under AA for different sexes. 2. The differences of the excellent rate of AA between Group A and Group B were extremely evident either in the positions of the tooth or the reason of tooth extraction. The former was 89.04% and the latter 76.20% (P less than 0.005). 3. Although a low rate in excellence of tooth extraction under simple AA (only 75.58%), not so good as the effect by AAA (an average about 88.21%), the simple AA was more common and more easier to be accepted by patients. 4. Tooth extraction under AA has been proved to be safe, effective and without any complications. 5. The reasons for the senior to extract their teeth were almost for the broken crowns and of roots or the purposes of prosthetic restoration. Even though the pain thresholds in the senior were commonly higher. It is still an important factor of the good effect and good rate of tooth extraction under AA. Referring to the statistics in this study the authors suggest that the hospitals which can use the AA for tooth extraction adopt the method as the first choice of anesthesia method to the senior who intends to accept it.
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PMID:[Analysing the effects of tooth extraction under acupuncture anesthesia in 825 cases of senior]. 187 94

Over a 1-year period, 242 patients with peripheral vascular disease underwent abdominal ultrasonography to detect the presence of an abdominal aortic aneurysm. In 34 (14 per cent) an abdominal aortic aneurysm was found; half of these aneurysms were greater than 4 cm in diameter. In addition, 16 patients had ectatic aortas. Abdominal aortic aneurysms were more common in men than in women (17 versus 8 per cent). Patients with claudication were as likely to have an abdominal aortic aneurysm as those with rest pain or gangrene. The presence of aortoiliac occlusive disease increased the chance of an aneurysm being present (P less than 0.02). Patients with occlusive peripheral vascular disease are a high-risk group with regard to the development of an abdominal aortic aneurysm. Patients with proximal occlusive disease represent a subgroup at even higher risk.
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PMID:Prevalence of abdominal aortic aneurysm in patients with occlusive peripheral vascular disease. 195 1

This report describes the case of an 80-year-old woman with a long history of chronic, stable angina pectoris who underwent resection of an abdominal aortic aneurysm and placement of an aortobifemoral bypass graft under a combination of epidural and general anesthesia. Epidural morphine was administered postoperatively for pain management. The patient suffered a massive myocardial infarction (MI) in the immediate postoperative period but experienced no chest pain or discomfort similar to her usual anginal symptoms. The use of epidural and spinal opioids in the treatment of anginal pain is reviewed and discussed in terms of the possibility that such epidural opioid therapy may have masked this patient's anginal symptoms.
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PMID:Acute myocardial infarction symptoms masked by epidural morphine? 203 43


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