Abodminal oartic aneurysm(AAA) occurs in approximately 2~4% of all population. The incidence of AAA is increasing recently. This may be due to better detection or to an actual in crease in the number of patients developing AAA. AAA is more common
in
men, is coexistent with hypertension in 40% of patients, and is associated with other peripheral aneurysm in 20% of cases.
AAA is not infrequently combined with concomitant distal arterial occlusive disease. This occlusion may be due to coexistet atherosclerosis of distal artery, distal thromboembolization or both. Pathology routinely reveals laminated clot and
intramural
thrombus in the presence of a very thin aortic wall.
From January 1983 to Aprill 1994, 63 patients with AAA who underwent surgery at Kangnam St. Mary's Hospital, Ctholic University Medical College, were evaluated. There were 52 men and 11 women of mean age 63.3 years. In 54 patients the original
pathology
was atherosclerosis. Most common clinical sign is abdominal or back pain in 23 cases(37%) followed by abdominal pulsatile mass(29%), claudication(17%), 2 cases of aneurysm-small bowel fistula with massive bleeding.
Caridac disease in 47 cases is te most common underlying disease, followed by chronic obstructive pulmnary disease(COPD) in 12 cases, diabetes mellitus in 8 cases. In frarenal aorta is less than 5 cm, 47 cases larger than 5 cm in maximal diameter
of the
aorta.
Computed tomography was mostly used in 35 cases for diagnosis, ultrasonography in 32 cases, aortography in 19 cases. The aorto-bifemoral bypass using Dacron graft was done in 13 cases and aorto-biiliac graft replacement in 30 cases, aorto-iliac
and
aorto-femoral graft replacement in 6 cases.
Two patients expired due to multiple organic failure. Emergency operation was done in 7 ruptured AAA, 4 of were them were survived and 3 were expired. The most common complication following surgery was wound infectio in 10 cases and the oter
complications were pulmonary complications, intestinal ileus, gastrointestinal bleeding(ulcer, gastritis), graft-duodenal fistula. AAA was a propensity for sudden rupture and death. Even peripheral atherosclerotic occlusion in leg could be
combined
with
hidden AAA. AAA should be actively sought and aggresively treated before rupture.
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