Abdominal aortic aneurysm: Difference between revisions
| Line 31: | Line 31: | ||
== Treatment == | == Treatment == | ||
#Rupture-EMERGENT SURG/Endovasc | #Rupture | ||
##-->EMERGENT SURG/Endovasc | |||
##Do not waste time for stablization --> OR | ##Do not waste time for stablization --> OR | ||
##T&C x 6-10U PRBCs, 4U FFP and 4U platelets | ##T&C x 6-10U PRBCs, 4U FFP and 4U platelets | ||
##Maintain BP high enough to keep asymptomatic end organ (like penetrating tauma) | ##Maintain BP high enough to keep asymptomatic end organ (like penetrating tauma) | ||
##Do not lower BP if R/O rupture (chronic ok) | ##Do not lower BP if R/O rupture (chronic ok) | ||
#Asymptomatic-Incidental finding: f/u Vascular | #Asymptomatic | ||
##-->Incidental finding: f/u Vascular | |||
== Source == | == Source == | ||
Revision as of 11:48, 12 March 2011
Background
- Infrarenal diameter >3cm or >50% increase in size of diameter
- Rupture Risk
- <4cm: low risk for rupture
- 4-5cm: 5 year risk 3-12%
- >5cm: 25-41%
- Rupture poss at any size, most commonly >5cm
Risk Factors
- Age
- Prevalence is negligible in age < 50 yrs
- Smoking
- Risk factor most strongly assoc with AAA
- Also promotes the rate of aneurysm growth
- Family history
- HTN
Diagnosis
- May be asymptomatic or abdominal/back pain
- Pain + AAA = rupture until proven otherwise
- Acute abdomen + BP = possible rupture
Workup
- US (cannot see rupture)
- CT Noncon (if stable)
Treatment
- Rupture
- -->EMERGENT SURG/Endovasc
- Do not waste time for stablization --> OR
- T&C x 6-10U PRBCs, 4U FFP and 4U platelets
- Maintain BP high enough to keep asymptomatic end organ (like penetrating tauma)
- Do not lower BP if R/O rupture (chronic ok)
- Asymptomatic
- -->Incidental finding: f/u Vascular
Source
Donaldson, Bessen, H-N, UpToDate