title: [Operation experience of atypical ruptured abdominal aortic aneurysm].
abstract: OBJECTIVE
  To evaluate and report surgical management and experience of atypical ruptured abdominal aortic aneurysm (RAAA).
  
  
  METHODS
  Clinical data of 52 RAAA patients from May 2002 to February 2015 were retrospectively collected and analyzed. Thirty-three cases were included into this study based on atypical clinical presentation and etiology, including 6 infected RAAA, 5 inflammatory RAAA, 1 traumatic aortic rupture, 6 tuberculotic RAAA, 2 aoritc-vena cava fistula, 3 intestinal fistula and 5 spine erosion cases. Two of them refused operation during preparation, 19 of them received emergency open repair and 13 of them received endovascular aortic repair (EVAR) with 1 case converted to open surgery.
  
  
  RESULTS
  The systolic blood pressure of atypical RAAA before operation was (88±16) mmHg (1 mmHg=0.133 kPa), duration time from admission to diagnosis making was (17±10) hours. Perioperative death occurred in 1 patient because of hemorrhagic shock induced acidosis. During follow-up for 3 to 72 months, no operation related complications occured, such as artificial graft infection.
  
  
  CONCLUSIONS
  Emergent operation including open surgery and EVAR is crucial for RAAA treatment. Early diagnosis, excellent operative techniques and comprehensive perioperative management are measures conducive to reduce the mortality rate of RAAA.
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China; Email: changshucsu@163.com.
authors.forename: Chang
authors.initials: C
authors.lastname: Shu
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Fang
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China.
authors.forename: Tun
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China.
authors.forename: Quanming
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha 410011, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures