CORREÇÃO DE ANEURISMA ABDOMINAL ROTO: RELATO DE CASO (Atena Editora)

Abstract

This report addresses the case of a 65-year-old man, who presented with abdominal pain, sweating and hypotension for 3 days and who, when looking for an emergency room, was diagnosed with a ruptured abdominal aortic aneurysm (AAAr), of the juxtarrenal type in anterior wall. He was referred and underwent emergency surgery for transperitoneal access repair. Abdominal aortic aneurysm (AAA) results from endothelial weakness that precedes the abnormal dilation of more than 50% of the arterial wall. AAAr is a surgical emergency, with a mortality rate of 80% to 90% of cases. About a third of patients die before reaching the hospital and only 50% of patients undergoing surgical repair survive the perioperative period. Tears can occur in the posterior, lateral or anterior wall of the abdominal aorta. Those on the posterior or lateral wall are tamponade by compression by adjacent structures, a fact that makes surgical correction feasible as the patient maintains hemodynamic stability. Anterior wall ruptures tend to progress with massive hemorrhages into the peritoneal cavity, as they do not progress with immediate packing, increasing the mortality rate in these cases. The relevance of this case lies in the rare clinical presentation of a pathology with high mortality in which there was tamponade of the anterior rupture by external factors, which enabled surgical correction. Mastering the different clinical presentations of this pathology is important for timely diagnosis and treatment, which has a positive impact on the morbidity and mortality of ruptured abdominal aortic aneurysms.