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Abdominal Aortic Aneurysm

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Topic updated on 08/14/17 12:59pm

Overview
 

 
Snapshot
  •  A 61-year-old male with a history of CAD and HTN is found to have an abdominal mass and abdominal bruit. The mass is pulsatile on physical exam.
Introduction
  • An aneurysmal dilation of the aorta  
  • Most commonly secondary to atherosclerosis
  • Most are abdominal
    • 90% originate below the renal arteries
  • Risk factors 
    • HTN
    • atherosclerosis
    • family history
    • smoking
    • males
    • increasing age
    • Marfan's syndrome
Presentation
  • Usually asymptomatic and discovered on exam or by imaging
  • Presentation
    • pulsatile sensation
    • back pain
    • vague epigastric pain
  • Physical exam
    • pulsatile mass in the abdomen
    • abdominal bruits
    • evidence of lower extremity arterial insufficiency
  • Ruptured aneurysm triad
    • hypotension
    • severe tearing pain radiating to the back (left flank pain)
    • pulsatile mass
Evaluation
  • Imaging
    • plain films may show calcified wall
    • abdominal ultrasound for diagnosis
    • CT is best modality to determine size 
    • aortogram for definitive diagnosis


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