Acute Abdominal Aortic Injury: An Analysis of Operative and Postoperative Management

Thirty-two acute abdominal aortic injuries were treated in the last five years. The overall mortality was 63%. Fifteen injuries involved the infrarenal portion of the aorta (mortality, 53%) and eight injuries involved the diaphragmatic or celiac portion of the aorta (mortality, 50%). There were nine injuries to the suprarenal or visceral aorta; the mortality was the highest in this group (89%). A thoracoabdominal approach with occlusion of the descending thoracic aorta and mobilization of the abdominal viscera from left to the midline to expose the aorta is employed. The use of fresh whole blood, fresh frozen plasma, and platelet concentrates are important adjuncts to the resuscitation when massive blood replacement is necessary.