Revista chilena de cirugía
versión On-line ISSN 0718-4026
ROJAS N, Reginald y ROJAS G, Andrés. Complications and mortality of ruptures abdominal aortic aneurisms in a rural setting. Rev Chil Cir [online]. 2006, vol.58, n.2, pp. 138-146. ISSN 0718-4026. doi: 10.4067/S0718-40262006000200011.
Background: The rupture of an aortic aneurism is associated with a high mortality. In isolated and rural areas, where patients must be transferred to a base hospital for treatment, this condition may become a real health risk. Aim: To assess the management and complications of ruptured abdominal aortic aneurisms (RAAA) in an isolated southern area in Chile. Material and Methods: Retrospective review of clinical records of 20 patients with RAAA admitted to a base hospital in Puerto Montt Chile. Results: Six patients (aged 56 to 78 years, five males) were admitted with a free rupture to the abdominal cavity. Three were operated, two declined surgery and one was deemed not eligible for surgical treatment. Only two patients were previously aware that they had an aneurism. The mean diameter of the lesion was 6.5 cm. Three smoked, two were hypertensive, two had coronary artery disease and two were diabetic. They had to be transferred from hospitals 13 km distant from the base hospital. The mean lapse required for derivation was 1.5 days and they were operated at a mean of 10 hours alter admission. All patients died. In 14 patients (aged 36 to 87 years, 10 males), the rupture formed a retroperitoneal hematoma and all were operated. Two were previously aware that they had an aneurism. Six smoked and five were hypertensive. Three patients did not have any concomitant disease. Ten were transferred from hospitals distant at a mean of 202 km and required a mean of 1.5 days to reach the base hospital. They were operated 10 hours after admission. Three patients, that were admitted with hypotension and in coma, died. Conclusions: Patients with ruptured aneurisms causing retroperitoneal hematomas had a better survival than those that had a free rupture to the peritoneal cavity
Palabras clave : Aortic aneurism; rural medicine; retroperitoneal hematoma.