Computed tomography in the evaluation of the patient with symptomatic abdominal aortic aneurysm.

Computed tomography was used to evaluate 25 hemodynamically stable patients with suspected leaking abdominal aortic aneurysms. Of 10 patients found to have the presence of free retroperitoneal blood, six underwent immediate operation and five survived (83%). Delay in operation uniformly resulted in death. There was one false-positive study. Twelve patients demonstrated no extravascular fluid on initial computed tomography interpretation. Unsuspected nonvascular problems were found in six patients (40%). There was one false-negative study that resulted in a death. Clinical findings at initial examinations were similar in both groups. We conclude that in the hemodynamically stable patient, combining prompt computed tomography evaluation and immediate operation optimizes outcome in patients with leaking abdominal aortic aneurysms.