Emergency surgery saved patient with abdominal aortic aneurysm rupture

Mr. Nguyen Dinh Tung (68 years old, in Hai Ba Trung District, Hanoi) was diagnosed with an aortic aneurysm 3 years ago and planned to receive a stentgraft at another hospital. However, on last Saturday morning (January 23), he was suddenly in severe abdominal pain, sweating, and experienced hypotension. He was taken to the emergency room at Vinmec International Hospital.

The CT scan showed a 6-centimetre aneurism, the aortic aneurism was leaking and bleeding into the retroperiton.  In the emergency situation, the doctors conducted resuscitation and surgery for the patient at the same time that night. Dr. Nguyen Hoang Ha, Head of Cardiovascular Surgery, Vinmec International Hospital, performed the surgery and said: “This is a very challenging surgery because of the rupture of the aortic aneurysm.  It was very difficult to analyze and control the aorta.  The surgery took 5 hours.  The doctors were able to control the bleeding and replace the abdominal aorta with an artificial aorta.  After 3 days the patient was stable, able to eat and walk slowly.  We expect that on March 2, the patient can be discharged.”

benh nhan vo phinh dong mach chu

After 3 days, the patient was stable; able to eat and walk slowly

During the surgery, most of the patient’s one liter of blood loss has been delivered back inside thanks to the blood auto-transfusion technique based on Cell saver equipment system.  Dr. Hoang Ha added, “The disease of abdominal aortic aneurysm is one of the leading causes of death in vascular diseases.  This disease is common in older patients (over 60 years old), more male than female (5/1).The factors that lead to this disease are high blood pressure, patients have atherosclerotic elsewhere, smoking and family history of aneurysms.  This disease is usually detected through routine health checks based on history, clinical findings and ultrasound.  When the swelling ruptures, patients have a very high mortality rate. This patient was very lucky because the swelling ruptured into the retroperitoneum, while the blood loss was slower, and he received surgery before the aneurysm ruptured completely.  Had the aneurysm totally ruptured, he would have had only a slight chance of surviving.

Dr. Ha recommends that when patients are diagnosed with abdominal aortic aneurysm, especially the aneurysm with high rupture risk (larger than 5 cm), they need to be treated as soon as possible by surgery to replace abdominal aorta or percutaneous intervention to put in an artificial vessel (stent graft).

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