Abdominal aortic aneurysm

Last reviewed: 7 May 2023
Last updated: 07 Aug 2020



History and exam

Key diagnostic factors

  • palpable pulsatile abdominal mass
More key diagnostic factors

Other diagnostic factors

  • abdominal, back, or groin pain
  • hypotension
Other diagnostic factors

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
  • increased height
  • central obesity
  • nondiabetic
More risk factors

Diagnostic investigations

1st investigations to order

  • abdominal ultrasound
More 1st investigations to order

Investigations to consider

  • erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP)
  • CBC
  • blood cultures
  • computed tomography angiography (CTA)/CT
  • magnetic resonance angiography (MRA)/MRI
More investigations to consider

Treatment algorithm


ruptured AAA

symptomatic, but not ruptured AAA


incidental finding: small asymptomatic AAA

incidental finding: large asymptomatic AAA

endovascular repair leak requiring treatment



Matt J. Bown, MB BCh, MD, FRCS, PGCert (Bioinformatics)

Professor of Vascular Surgery

Department of Cardiovascular Sciences

University of Leicester, Leicester Royal Infirmary




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




AD declares that he has no competing interests.


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.


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



RN declares that he has no competing interests.

William Pearce, MD

Chief of Division of Vascular Surgery

Department of Surgery

Northwestern Memorial Hospital




WP declares that he has no competing interests.

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