Abdominal aortic aneurysm: Difference between revisions
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*Infrarenal diameter >3cm or >50% increase in size of diameter | *Infrarenal diameter >3cm or >50% increase in size of diameter | ||
*Rupture Risk | *Rupture Risk | ||
*<4cm: low risk for rupture | **<4cm: low risk for rupture | ||
*4-5cm: 5 year risk 3-12% | **4-5cm: 5 year risk 3-12% | ||
*>5cm: 25-41% | **>5cm: 25-41% | ||
*Rupture poss at any size, most commonly >5cm | **Rupture poss at any size, most commonly >5cm | ||
===Risk Factors=== | |||
#Age | |||
##Prevalence is negligible in age < 50 yrs | |||
#Smoking | |||
##Risk factor most strongly assoc with AAA | |||
##Also promotes the rate of aneurysm growth | |||
#Family history | |||
#HTN | |||
== Diagnosis == | == Diagnosis == | ||
Revision as of 11:46, 12 March 2011
Background
- Infrarenal diameter >3cm or >50% increase in size of diameter
- Rupture Risk
- <4cm: low risk for rupture
- 4-5cm: 5 year risk 3-12%
- >5cm: 25-41%
- Rupture poss at any size, most commonly >5cm
Risk Factors
- Age
- Prevalence is negligible in age < 50 yrs
- Smoking
- Risk factor most strongly assoc with AAA
- Also promotes the rate of aneurysm growth
- Family history
- HTN
Diagnosis
- May be asymptomatic or abdominal/back pain
- Pain + AAA = rupture until proven otherwise
- Acute abdomen + BP = possible rupture
Workup
- US (cannot see rupture)
- CT Noncon (if stable)
Treatment
- Rupture-EMERGENT SURG/Endovasc
- Do not waste time for stablization --> OR
- T&C x 6-10U PRBCs, 4U FFP and 4U platelets
- Maintain BP high enough to keep asymptomatic end organ (like penetrating tauma)
- Do not lower BP if R/O rupture (chronic ok)
- Asymptomatic-Incidental finding: f/u Vascular
Source
Donaldson, Bessen, H-N, UpToDate