Abdominal Aortic Aneurysm Flashcards
What is the formal definition of an AAA?
Is the dilation of the aorta which is 1.5x its original size
Do they cause symptoms and when?
Often don’t cause symptoms until ruptured
What are the associated risk factors?
Think of atherosclerosis
- Age
- Smoking
- Marfan’s
- DM
- Ehler’s Danlos
- HTN
- Hyperlipidaemia
Where are they commonly found?
85% are found below the kidneys
When is it indicated for repair?
- > 5.5cm - Males
- > 5cm - Females
Rapid increase in size
Symptomatic
What are the signs and symptoms if they were to occur?
Abdominal pain Back pain Pulsatile sensation Radio femoral delay Bruits
What are the complications of AAA?
- Rupture
- Peripheral embolisation
- Acute aortic occlusion
- Aortocaval and aortoduodenal fistulae
What are signs and symptoms of an aortic rupture?
- Severe back pain, abdominal pain, groin pain, flank pain
- Hypovolaemic shock
- Low BP
- Tachycardia
- Flank ecchymosis
What is suggestive of flank ecchymosis (Grey Turner’s sign)?
Retroperitoneal bleed
What is used to determine diagnosis?
- Physical exam
- USS (screening)
- CT (gold standard)
What is the clinical triad for rupture of AAA?
- Shock
- Pulsatile mass
- Abdominal pain
What do you do if the AAA rupture triad is positive?
Surgery without investigation
What are the two methods of treatments?
- Conservative - control risk factors
- Surgery
What are the two forms of surgery?
- Open
- Closed
When is surgery indicated?
> 5.5cm
