Document Detail


Intra-abdominal packing for uncontrollable haemorrhage during ruptured abdominal aortic aneurysm repair.
MedLine Citation:
PMID:  15975836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intra-abdominal packing is a valuable adjunct in patients with abdominal trauma and uncontrollable bleeding but few data exist regarding early and late outcome associated with this technique in patients with ruptured abdominal aortic aneurysm (AAA). METHODS: Interrogation of a prospective vascular surgical database identified 23 patients (22 men; median age 69, range 59-82, years) with ruptured AAA who required intra-abdominal packing for control of coagulopathic haemorrhage after insertion of an aortic graft between January 1982 and December 2003. Co-morbidity, operative and outcome data were retrieved. RESULTS: Haemostasis was achieved and packs were removed within 48 h in 20 patients. In those patients who had a graft inserted, the peri-operative mortality rate was 12 of 23 (52%) patients (vs. 172 of 455 (38%) patients who were not packed, NS). Three (13%) patients developed early intra-abdominal sepsis, which was universally fatal: graft-enteric fistula, intra-abdominal abscess with necrotizing fasciitis of the abdominal wound, and infected retroperitoneal haematoma. Two of 11 (18%) survivors developed late graft-related infective complications: major aortic graft infection at 6 months and symptomatic infected para-anastomotic aortic false aneurysm at 39 months. Early and late intra-abdominal infective complications were significantly more common in patients who were packed than in those who were not (packed: five of 23, 22% vs. non-packed: five of 455, 1%; p < 0.001). CONCLUSION: These data demonstrate that intra-abdominal packing in coagulopathic patients with ruptured AAA can achieve an acceptable survival rate. However, this technique may be associated with an increased incidence of early and late intra-abdominal infective complications.
Authors:
D J Adam; R A Fitridge; S Raptis
Related Documents :
15122606 - Outcome of abdominal aortic aneurysm repair in the era of endovascular treatment.
15557896 - Midterm results of the multicenter trial of the powerlink bifurcated system for endovas...
17263996 - Outcomes of original and low-permeability gore excluder endoprosthesis for endovascular...
24290746 - Basic data from 176 studies on the immediate outcome after aortic valve replacement wit...
24692626 - A prospective, randomised trial comparing the use of absorbable and metallic screws in ...
23039706 - Thoracoscopic vertebral body stapling for treatment of scoliosis in young children.
Publication Detail:
Type:  Journal Article     Date:  2005-06-21
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  30     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-05     Completed Date:  2005-12-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  516-9     Citation Subset:  IM    
Affiliation:
University Department of Vascular Surgery, Birmingham Heartlands Hospital, Birmingham, UK. donald.adam@heartsol.wmids.nhs.uk
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / mortality,  surgery*
Aortic Rupture / mortality,  surgery*
Blood Vessel Prosthesis Implantation / adverse effects
Databases as Topic
Female
Hemorrhage / mortality,  surgery*
Hemostasis, Surgical / adverse effects,  methods*
Humans
Intraoperative Complications
Male
Middle Aged
Prospective Studies
Prosthesis-Related Infections / etiology
Sepsis / mortality
Tampons, Surgical*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The influence of oxygen tension on the induction of nitric oxide and prostaglandin E2 by mechanical ...
Next Document:  The immunogenicity of dendritic cell-derived exosomes.