When will I need an operation ?
Elective Operation
The decision to operate is a risk balancing exercise. On the one hand is the risk of rupture (with an 80% chance of dying). On the other hand is the risk of dying from the operation (about 8% if you are reasonably fit). The risk of operation increases with age (over 80 years) and co-existing heart, lung and kidney disease. Your consultant will discuss all of these risks with you before deciding on whether an operation is in your best interests or not.
Evidence from the recent UK Small Aneurysms Trial stated that operation should not be considered in patients aged 60 - 76 years and fit for surgery unless the aneurysm is more than 5.5 cm in diameter. If the patient is not so fit, surgery could be deferred until a larger size. If the patient is younger and fit, surgery could be considered at a smaller size (around 5cm).
Urgent / Emergency Operation
If the aneurysm causes abdominal pain or backache but has not ruptured it requires urgent repair. This is usually done on the next available operating list with an ITU (Intensive Treatment Unit) bed.
If the aneurysm has ruptured, the patient usually complains of severe sudden abdominal pain with collapse ('passing out' or feeling very faint as the blood pressure drops). This is an emergency situation requiring immediate operation unless there a strong reasons for not operating (e.g. the patient also has incurable cancer, severe uncorrectable heart or lung disease etc.).