Preoperative CT in symptomatic abdominal aortic aneurysms: accuracy and efficacy.
Of 80 patients who underwent operations for abdominal aortic aneurysm at the Gainesville Veterans Administration Medical Center, 23 had a preoperative CT scan. Twenty patients in this group were symptomatic. In determining the presence of rupture, there was only one false-negative examination and no false-positives for a sensitivity of 0.9 and a specificity of 1.0. Nine of the 20 symptomatic patients had a rupture confirmed at laparotomy, and these patients had a 22 per cent mortality. Unruptured symptomatic patients operated upon after an expeditious preparation (usually about 36 hr), including optimization of cardiac output and mechanical bowel cleansing, had a mortality of 30 per cent primarily for postoperative myocardial infarction and left ventricular failure. The high operative mortality previously reported for emergently repaired unruptured symptomatic abdominal aortic aneurysms (18%) was not diminished by limited preoperative preparation.
D000368:Aged; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards