Coexistence of abdominal aortic aneurysm and carcinoma of the colon: a dilemma.

The incidence of colonic cancer coexisting with an aneurysm of the abdominal aorta is approximately 2%. Such a coexistence presents a true dilemma to the surgeon for it is often difficult to decide whether to treat the carcinoma or the aneurysm first. This report summarizes the opinions of 46 Professors of General Surgery and Vascular Surgery who gave their response as to which condition should receive priority of treatment. Approximately one third of the respondents favored excision of the carcinoma first; one third stated they would excise the aneurysm first; and the remaining third said they would withhold a decision until laparotomy was performed. Two surgeons replied that they would attempt to perform aneurysmectomy and colectomy simultaneously.