Treatment of abdominal aortic aneurysms should be aggressive because less than 50% of untreated patients will be alive 3 years after diagnosis and most will die from ruptured aneurysm. In an effort to reduce the incidence of rupture, all abdominal aortic aneurysms should be excised unless the patient has a short life expectancy or very serious medical problems. In a series of 36 patients with ruptured abdominal aortic aneurysm the mortality was 42%. The main risk factors were blood loss, acute renal failure and major venous trauma. Multiple organ failure, which occurred in 8 of 15 patients often presents a therapeutic dilemma and worsens the prognosis.

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