Abdominal aortic aneurysm: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
==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 | ||
* <4cm: low risk for rupture | *<4cm: low risk for rupture | ||
* 4-5cm: 5 year risk 3-12% | *4-5cm: 5 year risk 3-12% | ||
* >5cm: 25-41% | *>5cm: 25-41% | ||
* Rupture poss at any size, most commonly >5cm | *Rupture poss at any size, most commonly >5cm | ||
'''Risk Factors:''' | '''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 | |||
* May be asymptomatic or abdominal/back pain | == Diagnosis == | ||
* Pain + AAA = rupture until proven otherwise | |||
* Acute abdomen + BP = possible rupture | *May be asymptomatic or abdominal/back pain | ||
*Pain + AAA = rupture until proven otherwise | |||
*Acute abdomen + BP = possible rupture | |||
== Workup == | == Workup == | ||
*US (cannot see rupture) | *US (cannot see rupture) | ||
*CT Noncon (if stable) | |||
== Treatment == | |||
==Treatment== | |||
Asymptomatic-Incidental finding: f/u Vascular | *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 == | ||
Donaldson, Bessen, H-N, UpToDate | Donaldson, Bessen, H-N, UpToDate | ||
[[Category:Cards]] | <br/>[[Category:Cards]] | ||
Revision as of 16:14, 9 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