Abdominal aortic aneurysm

Question 1

How common is it?

Answer 1

4% men and 1% of women over the age of 65

Question 2

Who does it affect?

Answer 2

Tends to be elderly men.

Question 3

What causes it?

Answer 3

Degenerative process. Genetic component

Question 4

What risk factors are there?

Answer 4

FHx

Marfans

Age

Question 5

How does it present?

Answer 5

Often there are no symptoms (70% of the time). It only causes symptoms if it has pressure effects or ruptures. Pressure effect symptoms may include mild abdo/back pains.

Blood clots can form on the insides of the aneurysm, that can break off and block other vessels.

If it ruptures, sudden, severe abdominal and back pain + collapse

Question 6

Signs on examination?

Answer 6

Large expansile mass.

Question 7

Investigations

Answer 7

USS or CT for diagnosis. There is now an USS screening programme.

Question 8

Treatment

Answer 8

Surgical replacement of the aneurysmal segment with a prosthetic graft is indicated for a symptomatic aneurysm or large asymptomatic aneurysms (>5.5cm)

In patients that are poor surgical risks, endovascular repair with insertion of an aortic stent is being increasingly employed.

BP management

Question 9

Conditions that would present similarly

Answer 9

Acute pancreatitis.

MI

GI haemorrhage.