Abdominal aortic aneurysm

Revision as of 22:34, 29 October 2010 by Robot (talk | contribs) (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

  • 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