腹主动脉瘤与其他同时需要外科手术干预的腹部外科疾病并存的情形不常见。有关的处理次序存在争议，焦点是选择同期还是分期处理共存的疾病，若选择分期手术，孰先孰后？ 治疗抉择应该依据病人的具体情况，例如动脉瘤破裂的风险、手术治疗的风险、恶性肿瘤的预后和病人的意愿等。应该优先处理威胁生命的疾病和症状明显的疾病。如病人的全身状态和局部的情况许可，应考虑同期手术治疗，这样可以避免再次手术和麻醉的创伤，而且免除了未治疗疾病的影响。主动脉瘤腔内修复术具有微创、可以早期和快速康复的优势，是理想的选择。在治疗与其他腹部外科疾病并存腹主动脉瘤时，先进行动脉瘤腔内修复术，病人经过短期的康复后再进行其他腹部外科疾病的治疗，这是有效的措施。

Treatment of abdominal aortic aneurysm with concomitant other surgical abdominal pathologies        LI Xiao-xi. Department of Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Abstract    The incidence of patients presenting with concomitant abdominal aortic aneurysm (AAA) and other abdominal pathologies of surgical interest is low. There is lack of consensus regarding to decide whether to concurrent or staged approaches, and the prioritisation of staged procedures. The management decision needs to be made for each individual case based upon the best estimates of risks of aneurysm rupture, operative risks, prognosis of malignancy, and patient preference. The most immediate life-threatening condition, the symptomatic lesion should be a treatment priority. Single-stage treatment avoids a second surgical and anesthesiologic trauma and eliminates the risks joined with the non-treated lesion, has to be preferred, when feasible for patient in general and local conditions. Endovascular aneurysm repair (EVAR), for its less invasiveness, early recovery and a shorter convalescence, appears to be the first choice for the patients. Staged treatment of AAA using EVAR followed by surgical therapy for other abdominal pathologies can be an effective therapy.