Summary
Definition
History and exam
Key diagnostic factors
- palpable pulsatile abdominal mass
Other diagnostic factors
- abdominal, back, or groin pain
- hypotension
Risk factors
- cigarette smoking
- hereditary/family history
- increased age
- male sex (prevalence)
- female sex (rupture)
- congenital/connective tissue disorders
- hyperlipidemia
- COPD
- atherosclerosis (i.e., coronary artery disease [CAD], peripheral arterial occlusive disease)
- hypertension
- central obesity
- nondiabetic
- European ethnicity
- fluoroquinolone antibiotics
- aneurysms elsewhere in the body
Diagnostic tests
1st tests to order
- abdominal ultrasound
Tests to consider
- erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP)
- CBC
- blood cultures
- computed tomography angiography (CTA)/CT
- magnetic resonance angiography (MRA)/MRI
Treatment algorithm
ruptured AAA
symptomatic, but not ruptured AAA
incidental finding: small asymptomatic AAA
incidental finding: large asymptomatic AAA
endovascular repair leak requiring treatment
Contributors
Authors
Matt J. Bown, MB BCh, MD, FRCS, PGCert (Bioinformatics)
Professor of Vascular Surgery
Department of Cardiovascular Sciences
University of Leicester, Leicester Royal Infirmary
Leicester
UK
Disclosures
MJB has grant funding from the British Heart Foundation and the National Institute for Health Research.
Andrew Duncan, MBBS, BSc, MRCS
Honorary Research Fellow
Department of Cardiovascular Sciences
University of Leicester
Leicester
UK
Disclosures
AD declares that he has no competing interests.
Acknowledgements
Professor Matt Bown and Mr Andrew Duncan would like to gratefully acknowledge Dr Maureen K. Sheehan, Dr Dawn M. Barnes, and Dr Gilbert R. Upchurch, previous contributors to this topic.
Disclosures
MKS, DMB, and GRU declare that they have no competing interests.
Peer reviewers
Ross Naylor, MBBS
Professor of Vascular Surgery
Vascular Surgery Group
Division of Cardiovascular Sciences
Leicester Royal Infirmary
UK
Disclosures
RN declares that he has no competing interests.
William Pearce, MD
Chief of Division of Vascular Surgery
Department of Surgery
Northwestern Memorial Hospital
Chicago
IL
Disclosures
WP declares that he has no competing interests.
Differentials
- Diverticulitis
- Ureteric colic
- Irritable bowel syndrome (IBS)
More DifferentialsGuidelines
- ACR appropriateness criteria: pulsatile abdominal mass, suspected abdominal aortic aneurysm
- ACR appropriateness criteria: screening for abdominal aortic aneurysm
More GuidelinesPatient information
Abdominal aortic aneurysm
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