Abdominal Aortic Aneurysm

Question 1

Risk factors

Answer 1

Age
Gender (male)
Smoking
Hypertension

Question 2

Pathogenesis

Answer 2

Affects the middle layer of the vessel wall (medial degeneration)
Dilation and weakening of the vessel wall
Increase in aortic wall stress
Progressive dilatation

Question 3

Presentation

Answer 3

Assymptomatic

• identified on imaging
• identified during surveillance

Symptomatic (rupture)

• sudden onset epigastric pain
• radiates to back
• patient may collapse

Question 4

Examination

Answer 4

Pulsatile, expansive mass which may be tender

Patient may look well

Question 5

Imaging

Answer 5

Duplex US - to assess size
CT scan - identify if ruptured or not
Aneurysm morphology

Question 6

Management

Answer 6

Assymptomatic
- >5.5cm AP diameter needs treatment

Symptomatic

• laparotomy
• endovascular aneurysm repair (x-ray guided)