Emergency surgery of patients with ruptured great vessels and profound shock.
From October 1986 to March 1989, a total of 7 patients who had preoperative profound shock underwent surgical treatment at the National Taiwan University Hospital for a ruptured aorta or vena cava. All 7 patients were men. Their age ranged from 21 to 70 years with a mean of 45 years. Emergency operations were performed due to a ruptured abdominal aortic aneurysm in 2, a ruptured dissecting thoracic aneurysm in 1, a penetrating injury which transected the intrahepatic vena cava in 2, and blunt chest injury which resulted in acute traumatic aortic transection in 2. One of these 7 patients died of acute tubular necrosis, anoxic encephalopathy and secondary sepsis, in spite of successful restoration of circulation. Two patients had postoperative complications. One had a transient paraparesis after an aortic cross-clamp, and the other had a transient impairment of the hepatic function due to the penetrating hepatic injury and the hypoxic hepatic damage. All 6 survivors were restored to an excellent state of health and had minimal post-resuscitation sequelae. We emphasize the importance of aggressive surgical treatment for those patients with the threat of impending death due to massive hemorrhage from a ruptured great vessel.
Chang
H
H
Department of Surgery, National Taiwan University Hospital, Taipei, R.O.C.
Hung
C R
CR
Lin
F Y
FY
Chu
S H
SH
D000328:Adult; D000368:Aged; D001012:Aorta, Abdominal; D001019:Aortic Rupture / Q000601:surgery*; D004630:Emergencies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012421:Rupture / Q000601:surgery; D012771:Shock, Hemorrhagic / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000293:injuries* / Q000601:surgery