Management of ruptured abdominal aortic aneurysm in a low resource environment

Abstract

Ruptured abdominal aortic aneurysm is a clinically catastrophic event and a dreaded complication of abdominal aortic aneurysm (AAA) because of its associated high mortality even in the developed countries with better equipped health infrastructure. An Aneurysm is defined as ruptured when bleeding is present outside of the wall of the Aneurysm. The resulting massive bleeding leads to hypotension and resultant multiple organ failure except very urgent
intervention is done to effect repair.

Repair can be very challenging because of the unstable cardiovascular hemodynamics and without repair; ruptured AAA is nearly always fatal.

Despite availability of advanced intensive care facilities to complement open surgical repair in
developed countries, postoperative mortality remains high. The advent of endovascular aneurysm repair appears promising but such technology is presently very rare or unavailable in low resource environment like ours. Prevention of AAA rupture should be emphasized by screening the people at risk and prompt medical and surgical management of AAA once identified.