Chapter 19: Ruptured and Leaking Abdominal Aortic Aneurysms

Ruptured or leaking abdominal aortic aneurysms are associated with a significantly high mortality rate, ranging from 50% to 80% in the preoperative period. The main determinant of survival is prompt diagnosis and emergent surgery. The classical presentation is the triad of a pulsatile abdominal mass, pallor and hypotension. These patients may give a preceding history of severe central abdominal pain with radiation to the back. In addition they have a significant history of smoking, hypertension and hyperlipidaemia. Frequently, there may not be enough time to elucidate such history from the patients.