To think about the most serious complication of Abdominal aortic aneurysm - the rupture is very important because even banal difficulties such as backache, epigastric pain or vomiting could be a harbinger of a lethal end. After asymptomatic period, condition can lead to hemorrhagic shock in few hours. Due to risk factors which are widely distributed in our population (smoking, hypertension, atherosclerosis, age) and the prevalence of aneurysm which is not negligible (2.5 – 5 %), the risk of rupture is very high. It depends on size – the risk of rupture 6 cm aneurysm in 5 years is 33 %, in case of aneurysm with diameter above 7 cm is up to 95 %.
Bronislav Stibor, MD, Senior physician, ICU, Landesklinikum Baden bei Wien, Austria
Educational algorithm aptly describes procedure of diagnostics and therapy decision-making process in this life-threatening disease. It emphasizes need of using complementary tests according to modern trend of acute and intensive medicine – especially imaging techniques and thrombelastography test including their perfect timing. Algorithm is logical and besides the correct procedure suggests the most common mistakes and wrong approach which can cost patient´s life. Given model case is very close to real situation which every anesthetist and intensivists must properly manage. Practicing the correct procedure is the best preparation to real situation. In contrast of educational algorithm, in real life “step back” is not an option.
Keywords: aneurysm of abdominal aorta, massive hemorrhage, hypovolemic shock
inserted: 27. 3. 2015 | last modified on: 12. 5. 2019