title: Management of symptomatic abdominal aortic aneurysms following emergency computed tomography.
abstract: OBJECTIVE
  It is still difficult to determine the appropriate timing of surgery for a symptomatic abdominal aortic aneurysm (AAA). Since recent developments in computed tomography (CT) have made the procedure substantially less time-consuming, we used CT on patients with symptomatic AAA to determine the most appropriate management option.
  
  
  METHODS
  CT was performed on 79 patients with symptomatic AAA. If rupture of the AAA was confirmed by CT, patients underwent emergency surgery. If there was no rupture, patients were observed in an intensive care unit, and surgery was scheduled according to the results of repeated CT (2.1 times on average) and physical examinations, as well as on their clinical signs and symptoms.
  
  
  RESULTS
  By CT, we identified 42 ruptures, one contained rupture, one aortocaval fistula, five acute aortic dissections with AAAs, six inflammatory AAAs, six pseudoaneurysms and 18 non-ruptured AAAs. The mortality rate of the patients with ruptures was 33%. For the 37 patients without rupture, as determined by CT, three emergency, nine urgent, and 20 elective operations were performed. Two patients who refused surgery experienced late rupture and died. Among the other 35 patients, the mortality rate was 6%.
  
  
  CONCLUSIONS
  CT was an effective modality to classify patients with symptomatic AAA into those who needed emergency surgery and those who did not. We could observe patients with symptomatic non-ruptured AAAs before urgent/elective operations by repeated CT and monitor the clinical findings.
authors: Department of Vascular Surgery, Ichinomiya Municipal Hospital, 2-2-22 Bunkyo, Ichinomiya, Aichi, 491-8558, Japan, matsu85@orihime.ne.jp.
authors: Masahiro
authors: M
authors: Matsushita
authors: Teruo
authors: T
authors: Ikezawa
authors: Masayuki
authors: M
authors: Sugimoto
authors: Akihito
authors: A
authors: Idetsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000601:surgery*; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036542:Tomography, Spiral Computed; D014218:Triage / Q000379:methods*