Abdominal aortic aneurysm: Difference between revisions

(Created page with "==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% * Ruptur...")
 
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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
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Risk Factors:
Risk Factors:
* Age
* Age
* Prevalence is negligible in age < 50 yrs  
* Prevalence is negligible in age < 50 yrs  
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* Family history
* Family history
* HTN  
* HTN  


==Diagnosis==
==Diagnosis==


* 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 + BP = possible rupture
* Acute abdomen + BP = possible rupture




Workup
== Workup ==


*US (cannot see rupture)
*US (cannot see rupture)


CT Noncon (if stable)
CT Noncon (if stable)


==Treatment==
==Treatment==


Rupture-EMERGENT SURG/Endovasc
Rupture-EMERGENT SURG/Endovasc
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-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 ==


Donaldson, Bessen, H-N, UpToDate
Donaldson, Bessen, H-N, UpToDate


[[Category:Cards]]
[[Category:Cards]]

Revision as of 07:04, 3 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)

-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