Twenty years' experience of surgical treatment of the ruptured atherosclerotic aneurysm of the abdominal aorta.

The results of surgical treatment of 209 ruptured abdominal aortic aneurysms are reviewed. The mortality over the first period of ten years was 37.8% and over the second ten years 44.9%. An attempt was made to analyse the reasons for this somewhat disappointing experience, shared by other authors. The broader indications for surgical treatment and the rise in the average age of our patients at presentation may be partially responsible. This elderly aged group had a greater incidence of coexistent disease leading to increased postoperative complications. The duration of preoperative shock had a direct inverse relationship to mortality. It is stressed that, apart from close collaboration between surgeon and internist with early detection of many postoperative complications such as gastrointestinal bleeding, anuria or heart failure, correct and early diagnosis of the ruptured aneurysm offers the best chance for the improvement in the survival rate of these patients.