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Ruptured Aortic Aneurysm — Emergency Management

A life-threatening haemorrhagic emergency that requires immediate diagnosis and surgical or endovascular repair.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Ruptured Aortic Aneurysm — Emergency Management?

Aortic aneurysm is permanent enlargement of the aortic wall to >50% of its normal diameter; rupture causes massive haemorrhage when it exceeds the elastic limit.

Eighty per cent of ruptures involve abdominal aortic aneurysms (AAA); thoracic ruptures progress more rapidly and have a mortality of 90%.

The classic triad is hypotension, abdominal/back pain and pulsatile mass; bedside ultrasound shortens diagnostic time.

Symptoms

Sudden severe abdominal/back pain ("tearing" character)
Hypotension and tachycardia (signs of shock)
Pulsatile abdominal mass
Cold, mottled skin and sweating
Confusion and loss of consciousness
Lower-limb pulse asymmetry
Flank ecchymosis (Grey-Turner sign)

Risk Factors

Male sex and age >65 years
Smoking (largest single risk factor)
Severe hypertension and atherosclerosis
Family history of aortic aneurysm
Connective tissue disease (Marfan, Ehlers-Danlos)
Chronic obstructive pulmonary disease
Aneurysm diameter >5.5 cm

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Emergency presentation by 112 ambulance is mandatory in any sudden abdominal/back pain and shock signs
  • A diameter >5.5 cm or rapid growth (>0.5 cm/6 months) requires elective surgery
  • Hypotensive patient must be operated within 30 minutes
  • Annual CT/USG follow-up is essential after diagnosis

Treatment Methods

01
Massive transfusion protocol (whole blood, plasma, platelet)
02
Permissive hypotension (target SBP 80–90 mmHg)
03
Open surgical repair (graft replacement)
04
Endovascular aneurysm repair (EVAR/TEVAR)
05
Bedside ultrasound (FAST) and rapid CT angiography
06
Intensive care monitoring postoperatively

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.