Last reviewed: 13 May 2021
Last updated: 10 Jun 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • palpable pulsatile abdominal mass

Other diagnostic factors

  • abdominal, flank, or back pain
  • hypotension
  • loss of consciousness
  • pallor
  • abdominal distension
  • fever

Risk factors

  • cigarette smoking
  • hereditary/family history
  • increased age
  • male sex (prevalence)
  • female sex (rupture)
  • congenital/connective tissue disorders
  • hyperlipidaemia
  • COPD
  • atherosclerosis (i.e., coronary artery disease [CAD], peripheral arterial occlusive disease)
  • hypertension
  • increased height
  • central obesity
  • non-diabetic
  • European ethnicity

Diagnostic investigations

Investigations to consider

  • cross match
  • clotting screen
  • erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP)
  • FBC
  • blood cultures
  • computed tomography angiography (CTA)
  • magnetic resonance angiography (MRA)/MRI
  • positron emission tomography-computed tomography (PET-CT)

Treatment algorithm

Contributors

Expert advisersVIEW ALL

Consultant Vascular Surgeon

University Hospitals of Leicester NHS Trust

Honorary Lecturer, College of Life Sciences

University of Leicester

Leicester

UK

Disclosures

GM declares that he has no competing interests.

BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:

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

Andrew Duncan MBBS, BSc, MRCS

Honorary Research Fellow

Department of Cardiovascular Sciences

University of Leicester

Leicester

UK

Disclosures

MJB has grant funding from the British Heart Foundation and the National Institute for Health Research. AD declares that he has no competing interests.

Peer reviewersVIEW ALL

Chair of Surgery

University of Hull

Honorary Consultant Vascular Surgeon

Hull University Teaching Hospitals NHS Trust

Hull

United Kingdom

Disclosures

IC declares he has no competing interests

Section Editor, BMJ Best Practice

Disclosures

AS declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

Disclosures

RW declares that she has no competing interests.

Drug Editor, BMJ Best Practice

Disclosures

AM declares that he has no competing interests.

Comorbidities Editor, BMJ Best Practice

Disclosures

JC declares that she has no competing interests.

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