Aneurisma de aorta abdominal roto




The present study OOsthe objective of both establishing a nursing in the Emergency room (E.R) for patients suspected, of OOvingruptured abdominal aortic aneurysms (RAAA) and reducing the morbidity and mortality rates. Twenty-three patients with acute abdominal pain were operated on in the emergency room of Clinical Hospital in the Unicamp between January 1990 and December 1995: twenty men and three women with ages varying ftom 44 to 80. Six patients (26,08%) OOdprevious knowledge of their illness and 17 (73,91%) didn t OOveany. Five patients (22%) OOdcome from other hospitaIs with wrong diagnostic: renal pain, pancreatic and vertebral spine pathology. Eighteen patients (78,26%) underwent urgent surgery and five patients (21,73%) were operated on in the Emergency room (E.R). From these, four had already undergone US, two had done CT and one had no exams. In the Urgency room (D.R), eight patients (34,78%) had undergone US and fifteen OOddone CT. The patients were separated in two groups: those who presented clinical characteristics oí ruptured aneurysm and were hospitalized within 24h and the others afier 24h. From the total of 23 patients, 13 did not survive. The acute myocardial infarction was the pathology, which caused high mortality rates. CONCLUSION: l-Surgery to correct RAAA showed that patients were nursed into the Emergency room with clinical evolution of ruptured afier 24h, showed a better post-operative prognosis than patients of ruptured before 24h; 2-The patients were nursed in the Urgency room comparing with those of Emergency room, showed a better prognosis in the post-operative. So, we conclude tOOtwhen there is strong medical suspicion of RAAA, patients must be immediately taken to the operating room; 3-Patients must be surgically treated within 24h ofthe first syrnptoms, considering tOOthe RAAA diagnosis is essentially clinical; 4-Patients taken into the Emergency room, with acute abdominal pain ofunknown cause, must be submitted to a sound surgery, OOvingin mind tOOthe result can be that of a tamponed RAAA; S-Patients with AAA history will OOveto undergo on operation to correct the rupture of the aneurysm; 6-Patients over 60 must OOvethe aorta evaluated through CT or US and the aneurysm prophylatically treated to prevent rupturing. With the achieved results, a proposed protocol was elaborated, translated into the following algorithm: ...Note: The complete abstract is available with the full electronic digital thesis or dissertations


aneurisma da aorta abdomen agudo emergencias cirurgicas

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