[Natural course of acute symptomatic abdominal aortic aneurysms].

Purpose Of The Study: To examine the natural course of acute symptomatic aneurysms of the abdominal aorta.

Patients And Methods: From 1995 to 2005, admitted to our clinic were a total of 29 patients presenting with acute symptomatic aneurysms of the abdominal portion of the aorta (hereinafter referred to as AAA). Any aneurysmal ruptures were excluded based on the findings of an ultrasonographic duplex study and computed tomography. Eight patients were operated on urgently, one of whom died. The causes of refusal to perform either an emergency or planned operative intervention in other patients were as follows: age over 90 years old, patient's refusal to undergo the operation, pronounced concomitant pathology, small dimensions of the aneurysm in a combination with complete arrest of the pain syndrome. The subject of the study was follow-up of non-operated patients.

Results: Over the time of follow-up, ten patients died of AAA rupture. AAA ruptured in 4 patients within the first 10 days after admission, with the rest having died of the AAA rupture averagely after 18 months. Of the remaining patients, three died of various causes not related to AAA, one having endured a successful planned resection of the AAA, and two non-operated patients are still alive. None of the patients with a small AAA died of a rupture during the early follow-up period.

Conclusion: According to our findings, about one fourth of acute symptomatic AAAs would develop within the first 24 hours after the beginning of the pain syndrome. It is impossible to predict the natural course of such AAAs based only on the aneurysm's diameter and degree of the pain syndrome. Perspective patients without pronounced accompanying pathology should be operated on urgently.