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Abstract

Objective:

To evaluate the incidence of misdiagnosis in ruptured abdominal aortic aneurysm and its effect on treatment and outcome.

Design:

Retrospective study.

Setting:

Teaching hospital, The Netherlands.

Subjects:

97 consecutive patients admitted with ruptured abdominal aortic aneurysm during the 5-year period, 1 January 1989–31 December 1993.

Main outcome measures:

Initial diagnosis, interval between onset of symptoms and admission, and mortality.

Results:

38 Patients (43%) presented with symptoms of their aneurysm exceeding nine hours prior to admission (range 10 hours to 14 days, median 2 days). Fifty patients (60%) were initially misdiagnosed by the referring practitioner. Ultrasonography was consistent with rupture in only 36/70 (51%). 52 Patients died (54%), (operative mortality 45 (46%)), and was not affected by delay in diagnosis or treatment.

Conclusions:

Although delay in diagnosis or treatment did not seem to affect mortality, improved awareness of non-specific presentations of (imminent) rupture will result in fewer misdiagnoses and earlier treatment. A group of patients will undoubtedly benefit from this as they can be operated on at a stage when expected mortality is lower. Copyright © 1998 Taylor and Francis Ltd.