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

A 77-year-old woman was admitted to hospital with massive upper gastrointestinal bleeding of obscure etiology and a palpable abdominal aortic aneurysm. A spontaneous aortoduodenal fistula, discovered at operation, was treated successfully by resection of the aneurysm, aortic closure, lateral duodenal repair and axillobilateral femoral grafting. The three clues to the correct diagnosis were: a palpable, pulsatile abdominal mass, recurrent abrupt cardiovascular collapse and significant upper gastrointestinal bleeding with no obvious source. The conventional method of treatment--aortic resection, duodenal repair, and intra-abdominal aortic grafting--is followed by secondary infection and aortic anastomotic bleeding, and by death in nearly 50% of the patients. The method of treatment used by the authors in this patient may be safer and deserves further consideration.
 ...
PMID:Spontaneous aortoduodenal fistula: successful treatment by extra-anatomic vascular bypass. 31 30

A series of 100 consecutive patients operated on for an abdominal aortic aneurysm, whether cold or as emergency, but excluding those cases with circulatory collapse, has enabled us to define the post-operative prognosis after a follow-up of a maximum of ten years. The operative mortality of 12% was due essentially to coronary and renal complications. All of the survivors, except one, were available for review. Five years after the operation 64% were still alive, and the figure was 46% at eight years. These figures confirm the indication for systematic surgical treatment as soon as an aneurysm is discovered, unless any of the contra-indications which are discussed are present. The best method of following up small aneurysms (with a diameter of less than 6 cms) discovered in elderly subjects would be by echotomography.
 ...
PMID:[Long term results of surgical treatment for aneurysms of the abdominal aorta]. 41 76

Over an eight-year peroid at NCBH, 33 patients were operated for ruptured abdominal aortic aneurysm. Factors associated with an increased mortality included preoperative blood urea nitrogen levels of more than 20 mg per cent, severe preoperative hypotension, duration of symptoms of less than 24 hours, free peritoneal rupture and blood transfusions of greater than 19 units. Preoperative hypotension was the most selective preoperative prognostic parameter. From a review of this and other reported series, it was concluded that reduced mortality from ruptured abdominal aortic aneurysm can best be achieved by prompt diagnosis followed by surgical treatment before cardiovascular collapse can occur.
 ...
PMID:Ruptured abdominal aortic aneurysms: review of 33 cases treated surgically and discussion of prognostic indicators. 126 83

Ruptured abdominal aortic aneurysm classically presents with abdominal pain radiating to the back, a pulsatile abdominal mass and circulatory collapse. However, other symptoms may be the only presenting complaint. We report the case of a patient who presented with a history of acute retention of urine relieved by catheterisation, but who then developed clinical features more typical of abdominal aortic aneurysm rupture.
 ...
PMID:Ruptured abdominal aortic aneurysm presenting with acute urinary retention. 141 63

Certain clinical and autopsy findings are described in 13 patients who had both aortic dissection (AD) and fusiform abdominal aortic aneurysm (AAA). All 13 patients had severe and extensive aortic atherosclerosis. The AAA was diagnosed clinically in 9 patients, and 5 had the AAA resected. The AD was diagnosed clinically in 5 patients, and 2 underwent attempted operative repair. Two patients who had the AAA resected because of suspected rupture were found later to have ruptured a more proximal AD. Thus, AD occurs occasionally in patients who have AAA. In older persons with suspected rupture of an AAA, a more proximal rupture of an AD should be ruled out. When both AAA and AD are present in the same patient, the AD is more likely the cause of cardiovascular collapse than is rupture of the AAA.
 ...
PMID:Combined thoracic aortic dissection and abdominal aortic fusiform aneurysm. 843 Oct 87

A successful emergency operation for a 75-year-old man with aorto-caval fistula secondary to rupture of the abdominal aortic aneurysm is reported. A definite diagnosis of aorto-caval fistula was made by echography with characteristic engorgement of the caval vein. Clinical signs and symptoms characterized by lung edema, sudden onset, and circulatory collapse were also noticeable. In the operation, the fistula was closed via inside of the aneurysm with several mattress sutures following control of aortic flow and opening of the aneurysm. Back-flow of the blood through the fistula was readily controlled by finger tip. The aneurysm was replaced conventionally by a vascular prosthesis. There might be several suitable surgical selection available properly to individual case. No delay in surgical treatment depending on definite diagnosis by echography in such urgent condition should be stressed.
 ...
PMID:[Aorto-caval fistula due to a ruptured abdominal aortic aneurysm--an emergency operation following echoic diagnosis]. 328 24

Three cases of apparent anaphylactoid reactions to zomepirac sodium (Zomax) are reported. One patient initially appeared to have a dissecting abdominal aortic aneurysm with vascular collapse. The second patient experienced conjunctival pruritus after each of several doses of zomepirac before emergency department presentation with acute dyspnea and urticaria. The third patient had been admitted previously with a diagnosis of rule out myocardial infarction, which in retrospect was probably a zomepirac reaction. All three recovered uneventfully.
 ...
PMID:Anaphylactic reactions to zomepirac. 397 Apr 5

Massive pulmonary embolism associated with total cardiovascular collapse occurred during the surgical repair of a ruptured abdominal aortic aneurysm with an aortocaval fistula. Pulmonary artery pressure monitoring permitted immediate diagnosis whereas central venous pressures did not reflect the obstruction to right ventricular outflow. Pulmonary embolectomy without cardiopulmonary bypass was performed successfully.
 ...
PMID:Intraoperative diagnosis and treatment of massive pulmonary embolism complicating surgery on the abdominal aorta. 687 Oct 62

Over a 5-year period a prospective audit was carried out on 1131 patients undergoing surgery for abdominal aortic aneurysm (AAA) in the northern region. A total of 470 operations was performed in teaching hospitals and 661 in district hospitals; emergency operations accounted for 41.5 per cent. The overall mortality rate was 25.8 per cent; for emergency cases this value was 50.0 per cent. Mortality rates for elective surgery were 3.9 per cent in teaching and 12.0 per cent in district hospitals. Patients with ruptured AAA admitted via the accident and emergency department had a higher mortality rate (64.3 per cent) than those admitted by their general practitioner (49.5 per cent) or those referred from the urology department (18.8 per cent). In all, 73 (6.5 per cent) patients were admitted with an alternative diagnosis, ranging from collapse of unknown cause (25) to torsion of the testes (one) and colonic obstruction (one). Age had a profound effect on mortality rates. For emergency cases the mortality rate varied from 47.0 per cent (in teaching plus district hospitals) in those aged less than 80 years to 70.1 per cent in those 80 years or over (chi 2 = 7.22; P = 0.007). For elective surgery the mortality rate varied from 7.6 per cent (in teaching plus district hospitals) in those under 80 years to 23.8 per cent in those 80 years or over (P = 0.0006). The overall mortality rate of 25.8 per cent is significantly less than that quoted in the Confidential Enquiry into Perioperative Deaths report of 1987. Furthermore, elective patients over 80 years of age may expect a survival rate of 76 per cent and, in the absence of major medical contraindications, should not automatically be denied surgery. Importantly, it is of note that this prospective audit identified 31 per cent more cases than recognized by regional audit data.
 ...
PMID:Prospective audit of abdominal aortic aneurysm surgery in the northern region from 1988 to 1992. Northern Vascular Surgeons Group. 764 4

We report three cases in which ruptured aneurysm and aortocaval fistula went undetected until surgery was performed. Preoperative features suggestive of an arteriovenous fistula were not apparent in any of these patients; they all presented with cardiovascular collapse and all underwent emergency laparotomy after a ruptured abdominal aortic aneurysm was diagnosed. The fistula was discovered unexpectedly only after the aneurysmal sac was opened and the thrombus evacuated. In the first two patients the fistula was successfully sutured from within the aneurysmal sac. The first patient died 1 week postoperatively from rupture of a previously known associated thoracic aortic aneurysm and the second patient died during the operation from excessive blood loss. The third patient had a large fistula requiring an interposition synthetic graft to restore the continuity of the vena cava; the graft has remained patent 15 months postoperatively. Aortocaval fistula is an uncommon complication of aneurysmal aortic disease and may coexist with a rupture of the aneurysm into the retroperitoneum. In emergency cases such as ours it is usually discovered unexpectedly during the operation. The established method of treatment is to oversew the fistula from within the aneurysm; however, when the fistula is large reconstruction of the infrarenal inferior vena cava with an interposition synthetic graft is a good alternative to caval ligation.
 ...
PMID:Primary aortocaval fistula in association with ruptured aneurysms. 781 88


1 2 3 4 Next >>