Ruptured abdominal aortic aneurysms early recognition, hemodynamic stabilization, and emergency vascular surgery

Authors

  • Ahmed Amin Aljefri Department of Emergency Medicine, Al Thager Hospital, Jeddah, Saudi Arabia
  • Ahmed Abdulhadi Alhajji ICU, Al-Ahsa Health Cluster, Al Ahsa, Saudi Arabia
  • Fahad Waed Al Shammari Department of General Surgery, King Khalid Hospital, Majmaah, Saudi Arabia
  • Esra Salman Al Habib Department of Emergency Medicine, Jubail General Hospital, Jubail, Saudi Arabia
  • Mohammed Ghanem Alanazi Emergency Nursing Department, Armed Forces Hospital, Al Kharj, Saudi Arabia
  • Anfal Sayed Esam Department of General Surgery, Bahrain Defense Forces Hospital, Riffa, Bahrain
  • Faisal Abdullah Alghamdi Medical Administration of the Land Forces, Armed Forces Hospital, Dhahran, Dhahran, Saudi Arabia
  • Hassan H. Alajmi Department of General Surgery, Jahra Hospital, Al Jahra, Kuwait
  • Nojoud Mohammed Basahal College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
  • Khadijah Mohammed Qattan College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
  • Abdullah Abdulrahman Alwakeel College of Medicine, University of Tabuk, Tabuk, Saudi Arabia

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20233853

Keywords:

Ruptured abdominal aortic aneurysms, Vascular emergency, Hemodynamic stabilization, Emergency vascular surgery, Aneurysms

Abstract

Ruptured abdominal aortic aneurysms (rAAAs) are extremely dangerous. Require attention. This thorough review explores the management of rAAA, focusing on the detection stabilizing blood flow and emergency vascular surgery. Recognizing symptoms such as intense abdominal pain, low blood pressure, a pulsating mass in the abdomen, signs of reduced blood flow to the lower limbs, and back pain is crucial for quick identification. Diagnostic imaging techniques like ultrasound and computed tomography angiography (CTA) play a role in confirming the diagnosis and assessing the risk involved. Properly managing hemodynamics by balancing resuscitation efforts with approaches is essential to control ongoing bleeding. Emergency vascular surgery options include aneurysm repair (EVAR) and open repair; the choice depends on factors like anatomy, stability of blood flow, and surgical expertise. Prioritizing optimization to address any health conditions and closely monitoring patients after surgery greatly contribute to overall success rates. A collaborative approach among healthcare professionals ensures a multidisciplinary strategy during the period emphasizing effective communication. This comprehensive approach aims for outcomes in dealing with challenging rAAAs while considering advancements in research and clinical practices.

References

Takei Y, Tezuka M, Saito S, Ogasawara T, Seki M, Kato T, et al. A protocol-based treatment for ruptured abdominal aortic aneurysm contributed to improving aorta-related mortality: a retrospective cohort study. BMC Cardiovasc Disord. 2023;23(1):436.

Troisi N, Bertagna G, Torri L, Canovaro F, D'Oria M, Adami D, et al. The Management of Ruptured Abdominal Aortic Aneurysms: An Ongoing Challenge. J Clin Med. 2023;12(17):5530.

Sun Z, Al Moudi M, Cao Y. CT angiography in the diagnosis of cardiovascular disease: a transformation in cardiovascular CT practice. Quant Imaging Med Surg. 2014;4(5):376-96.

Menon BK, Demchuk AM. Computed Tomography Angiography in the Assessment of Patients With Stroke/TIA. Neurohospitalist. 2011;1(4):187-99.

Hong H, Yang Y, Liu B, Cai W. Imaging of Abdominal Aortic Aneurysm: the present and the future. Curr Vasc Pharmacol. 2010;8(6):808-19.

Midwinter MJ, Woolley T. Resuscitation and coagulation in the severely injured trauma patient. Philos Trans R Soc Lond B Biol Sci. 2011;366(1562):192-203.

Chatrath V, Khetarpal R, Ahuja J. Fluid management in patients with trauma: Restrictive versus liberal approach. J Anaesthesiol Clin Pharmacol. 2015;31(3):308-16.

Kessler V, Klopf J, Eilenberg W, Neumayer C, Brostjan C. AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis. Biomedicines. 2022;10(1):94.

Berman L, Curry L, Gusberg R, Dardik A, Fraenkel L. Informed consent for abdominal aortic aneurysm repair: The patient's perspective. J Vasc Surg. 2008;48(2):296-302.

Ay N, Derbent A, Şahin AS, Yalcin N, Çelik M. Variables affecting mortality rates in patients undergoing emergency abdominal surgery: A retrospective cross-sectional study. Ulus Travma Acil Cerrahi Derg. 2023;29(4):505-13.

Sheetz KH, Waits SA, Krell RW, Campbell DA, Englesbe MJ, Ghaferi AA. Improving mortality following emergent surgery in older patients requires focus on complication rescue. Ann Surg. 2013;258(4):614-7.

Durrand J, Singh SJ, Danjoux G. Prehabilitation. Clin Med (Lond). 2019;19(6):458-64.

Molenaar CJL, Papen-Botterhuis NE, Herrle F, Slooter GD. Prehabilitation, making patients fit for surgery - a new frontier in perioperative care. Innov Surg Sci. 2019;4(4):132-8.

Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40(12):1795-815.

Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cífková R, Dominiczak AF, Grassi G, Jordan J, Poulter NR, Rodgers A, et al. Hypertension. Nat Rev Dis Primers. 2018;4:18014.

Hussain S, Mubeen I, Ullah N, Shah SSUD, Khan BA, Zahoor M, et al. Modern Diagnostic Imaging Technique Applications and Risk Factors in the Medical Field: A Review. Biomed Res Int. 2022;2022:5164970.

Looking for Trouble: Identifying and Treating Hypotension. P T. 2019;44(9):563-5.

Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. Clin Biochem Rev. 2016;37(2):85-98.

Natarajan B, Patel P, Mukherjee A. Acute Lower Limb Ischemia-Etiology, Pathology, and Management. Int J Angiol. 2020;29(3):168-74.

Misra S, Shishehbor MH, Takahashi EA, Aronow HD, Brewster LP, Bunte MC, et al. Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association. Circulation. 2019;140(12):657-672.

Woodward L, Alsabri M. Permissive Hypotension vs. Conventional Resuscitation in Patients With Trauma or Hemorrhagic Shock: A Review. Cureus. 2021;13(7):e16487.

Ramesh GH, Uma JC, Farhath S. Fluid resuscitation in trauma: what are the best strategies and fluids? Int J Emerg Med. 2019;12(1):38.

Downloads

Published

2023-12-20

How to Cite

Aljefri, A. A., Alhajji, A. A., Al Shammari, F. W., Habib, E. S. A., Alanazi, M. G., Esam, A. S., Alghamdi, F. A., Alajmi, H. H., Basahal, N. M., Qattan, K. M., & Alwakeel, A. A. (2023). Ruptured abdominal aortic aneurysms early recognition, hemodynamic stabilization, and emergency vascular surgery. International Journal Of Community Medicine And Public Health, 11(1), 434–438. https://doi.org/10.18203/2394-6040.ijcmph20233853

Issue

Section

Review Articles