Abdominal aortic aneurysm: Difference between revisions
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*May be asymptomatic or abdominal/back pain | *May be asymptomatic or abdominal/back pain | ||
*Pain + AAA = rupture until proven otherwise | *Pain + AAA = rupture until proven otherwise | ||
*Acute abdomen + | *Acute abdomen + hypotension = possible rupture | ||
== Workup == | == Workup == | ||
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== Treatment == | == 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 == | == Source == | ||
Revision as of 16:50, 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 + hypotension = 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