Abdominal aortic aneurysm: Difference between revisions
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== Background == | == Background == | ||
*Infrarenal diameter >3cm or >50% increase in size of diameter | *Infrarenal diameter >3cm or >50% increase in size of diameter | ||
*Rupture Risk | *Rupture Risk | ||
| Line 9: | Line 8: | ||
===Risk Factors=== | ===Risk Factors=== | ||
#Age | #Age | ||
##Prevalence is negligible in age < 50 yrs | ##Prevalence is negligible in age < 50 yrs | ||
| Line 25: | Line 23: | ||
== Workup == | == Workup == | ||
* | *Ultrasound | ||
*CT Noncon | **>90% sensitivity for increased diameter | ||
**Cannot reliably visualize rupture | |||
*CT Noncon | |||
**If stable | |||
== Treatment == | == Treatment == | ||
*Rupture | *Rupture | ||
** | **1. Immediate surgery consultation | ||
** | **2. BP control | ||
** | ***Controversial | ||
** | ****Too little (ischemia), too much (incr bleeding) | ||
** | ****LOC may be better guide than BP | ||
**3. Pain control (avoid hypotension) | |||
*Asymptomatic | *Asymptomatic | ||
**- | **Promt vascular surgery outpatient follow-up | ||
== Source == | == Source == | ||
Revision as of 17:33, 28 May 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
- Sudden, severe abdominal/back pain
- Syncope (10%)
- Pain + AAA = rupture until proven otherwise
- Acute abdomen + hypotension = possible rupture
Workup
- Ultrasound
- >90% sensitivity for increased diameter
- Cannot reliably visualize rupture
- CT Noncon
- If stable
Treatment
- Rupture
- 1. Immediate surgery consultation
- 2. BP control
- Controversial
- Too little (ischemia), too much (incr bleeding)
- LOC may be better guide than BP
- Controversial
- 3. Pain control (avoid hypotension)
- Asymptomatic
- Promt vascular surgery outpatient follow-up
Source
Tintinalli, UpToDate