Surgical treatment of ruptured abdominal aneurysms. Factors influencing outcome.

The preoperative course and the postoperative results in 44 patients with ruptured abdominal aortic aneurysms were analyzed with particular emphasis on determining the reasons for the continuing high mortality rate. It was found that rupture was usually a process of staccato progression in pathologic events and a deteriorating clinical course. In cases in which the diagnosis was suspected and operation was performed soon after rupture, the risk was not significantly greater than that of elective aneurysmectomy. When operation was delayed until shock was established, the mortality rate rose precipitously.