Essentials of Diagnosis for AAA.
1. Most AAA are asymptomatic, detected by during a routine physical exam or a diagnostic study.
2. Severe back pain, or abdomnal pain, a pulsatile mass, and hypotension indicate rupture.
3. Concomitant atherosclerotic occlusive disease of the lower extremities is present nin 25% of patients.
Tips
1. >90% of AAA is infrarenal.
2. The older, the more risk.
3. Family hx is important.
4. >3.5 cm in diameter of abdominal aorta -- screen yearly for size increase (study shows 10% increase per year).
5. >5cm in diameter, do elective surgical repair.
6. Catch AAA rupture if at all possible and put the patient on surgical table ASAP.
7. Remember AAA in ER setting at all times.
8. Check atherosclerotic disease in other areas of the body.
Complications of the repair - elective
1. MI
2. Bleeding
3. Respiratory insufficiency.
4. Stroke.
Complications of the repair - Emergency repair esp when repair requires supraceliac or suprarenal cross clamping.
1. Bowel infarction
2. Liver dysfunction
3. Acalculous cholecystitis
4. Renal failure
