Abdominal Aortic Aneurysm

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Presentation :

• Most chronic AAAs are asymptomatic
• Signs and symptoms of a ruptured AAA include new abdominal, flank, or back pain; hypotension; syncope; and sudden collapse and shock.

Pathophysiology :

Diagnostic Testing:

• Ruptured AAA best diagnosed with CT or MRA
  • Ultrasonography is NOT accurate for diagnosing a ruptured abdominal aorta.
• One-time ultrasonographic screening is indicated to detect an asymptomatic AAA in any man between the ages of 65 and 75 years who has ever smoked
  • Can also screen selected men ages 65 to 75 years who have never smoked if other risk factors (e.g., family history of AAA).
  • Do not screen asymptomatic women for AAA.
• Abdominal ultrasonography surveillance intervals are based on aortic diameter:
  • <4 cm → every 2 to 3 years
  • 4.0-5.5 cm → every 6 to 12 months

Treatment :

• Schedule surgical or endovascular repair of AAAs w/ diameter ≥5.5 cm for males >5.0 cm in females OR those growing ≥0.5 cm per year, or symptomatic AAAs.
• Ruptured AAA requires emergent surgery or endovascular repair.
• 

Prognosis:

References:

• MKSAP
• UTD