Study note

Abdominal aortic aneurysm: common presentations

THE CONTEXT

An abdominal aortic aneurysm (AAA)* may be detected incidentally or present with pain, thromboembolism, compression or rupture.

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An AAA may be discovered on physical examination or plain X-ray, but most commonly on abdominal ultrasound.

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Even large AAAs can be difficult to palpate, allowing many to remain undetected until rupture.

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Pain may occur in the central abdomen, back, loin, iliac fossa or groin.

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Thrombus within the aneurysm sac may embolise to the lower limbs. Less commonly, the aorta undergoes thrombotic occlusion.

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Duodenal compression may cause obstruction and vomiting.

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Inferior vena cava compression may cause oedema and deep vein thrombosis.

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Rupture may occur into the retroperitoneum, peritoneal cavity or surrounding structures.

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The inferior vena cava is the most common surrounding structure involved in rupture, producing an aortocaval fistula.

NEETx

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