Abdominal Aortic Aneurysm

Question 1

Define abdominal aortic aneurysm

Answer 1

Permanent pathological dilation of the aorta (>1.5x)

Question 2

What are the causes/risk factors of AAA?

Answer 2

Causes
• Trauma
• Infection (aortitis e.g. syphilis)
• Connective tissue disorders e.g.
Marfan’s
• Atherosclerosis
• Vasculitis (Kawasaki’s, Behçet’s
Takayasu’s, GCA)

Risk Factors
• Male
• Age
• Smoking
• Family history
• Atherosclerosis
• Connective tissue disorders

Question 3

What are the symptoms of AAA?

Answer 3

• Asymptomatic
• Chest, neck pain
• Abdominal, back or groin pain

Question 4

What are the signs of AAA?

Answer 4

• Aortic regurgitation
• Pulsatile abdominal mass
• Hypotension
• Livedo reticularis
• Trash foot

Ruptured AAA
• Cyanosis
• Mottling
• Altered mental status
• Tachycardia
• Hypotension
• Grey-Turner sign (retroperitoneal
haemorrhage)

Question 5

What investigations are carried out for AAA?

Answer 5

• abdominal ultrasound - abdominal aortic dilation of >1.5 times the expected anterior-posterior diameter of that segment

Investigations to consider
• erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) - elevated
• FBC - leukocytosis, anaemia
• blood cultures - posistve
• computed tomography angiography (CTA)/CT - abdominal aortic dilation of >1.5 times the expected anterior-posterior diameter of that segment
• magnetic resonance angiography (MRA)/MRI - abdominal aortic dilation of >1.5 times the expected anterior-posterior diameter of that segment