Aortic Aneurysm

Question 1

Presentation of AAA

Answer 1

-Severe, central abdominal pain radiating to the back
-Pulsatile, expansible mass in abdomen
-Shock (hypotension, tachycardiac)
-Compression of duodenum (obstruction and vomiting)
-Inferior vena cava (oedema and deep vein thrombosis)
-Thromboembolic complications
-Aortic regurgitation
-Stridor, hoarseness (recurrent laryngeal nerve)
-Superior vena cava syndrome

Question 2

Investigations of AAA

Answer 2

-Ultrasound.
=Large 5.5cm, aneurysm >50% normal, usually below renal arteries

Question 3

Management of AAA

Answer 3

-Open AAA repair
-Endovascular aneurysm repair

Question 4

Emergency management of ruptured AAA

Answer 4

-Immediate vascular review
-CT angiogram if stable
-Surgical repair
-Palliative approach

Question 5

Describe the screening programme for AAA

Answer 5

-Single abdominal ultrasound for males aged 65.
=Small aneurysm= rescan 12 months (3-4.4cm)
=Medium= 3 months (4.5-5.5cm)
=Large (>5.5)= refer within 2 weeks vascular surgery for elective endovascular repair/ open repair (stent)