Abdominal Aortic Aneurysm Flashcards
Define Abdominal Aortic Aneurysm
The dilation of the abdominal aorta which can lead to a life-threatening rupture
What is the basic pathophysiology of abdominal aortic aneurysm?
- It is the dilation of the abdominal aorta wherein the diameter exceeds greater than 50% of the vessel diameter (>3cm)
- It is the degradation of all 3 layers of the vessels (intima, media and adventitia)
What is a true aneurysm?
Degradation of all 3 layers
What is a pseudoaneurysm?
degradation of less than 3 layers
What is dilation usually?
3cm+
What length of dilation means there is an increased risk of rupturing and a surgical emergency?
5.5cm+
What is inflammatory AAA?
- a type of AAA that affects younger patients
- associated with smoking, atherosclerosis and vasculitis
What is thoracic AAA?
- typically a result of Marfan Syndrome or Ehler-Danlos Syndrome(connective tissue disorders) and atherogenesis
- This is another rare type of AAA
What are the symptoms of AAA?
Typically asymptomatic until rupture
What are the rupture symptoms of AAA?
Pulsatile and expansile abdominal mass
Hypotension and tachycardia (Haemodynamically unstable)
Sudden epigastric pain radiating to the back or groin
Loss of consciousness
What is the % and prognosis for anterior and posterior AAA ruptures?
- 20% of AAAs rupture anteriorly, with a poor prognosis
- 80% rupture posteriorly with a better prognosis
What is the mortality rate in untreated ruptured AAA?
100%
What are the signs of AAA?
- Grey-Turner’s Sign: Flank Bruising
- Cullen’s Sign: Pre-umbilical Bruising
However, acute pancreatitis is also linked to these signs.
What are the risk factors for AAA?
Smoking
Age
Diabetes
Hypertension
Marfan Syndrome/Ehler Danlos Syndrome
Male
Family History
How do you diagnose AAA?
- Abdominal Ultrasound is usually used for establishing an AAA diagnosis
- It is fast, cheap and reliable as well as highly specific and sensitive
