This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Diagnosis of abdominal aortic aneurysm (AAA)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

diagnosis

AAA is often diagnosed incidentally following imaging studies such as abdominal ultrasonography or CT (1).

A medical history is helpful in determining the patient's risk of developing an AAA.

  • enquiry should be made regarding any risk factors which may be present
    • family history of aneurysm
    • special consideration should be paid to the cardiovascular system in the functional enquiry (2).

On examination:

  • palpation of the abdomen
    • pulsatile mass should be palpated (palpation has not been reported to precipitate aortic rupture)
    • accuracy of palpating a pulsatile mass around the level of the umbilicus is greatly reduced by obesity, abdominal distention, and smaller aneurysm size
      • a small prospective study reported that
        • sensivitity of abdominal palpation by a doctor was 0.57 for detection of aneurysms less than 4 cm diameter and 0.98 for those over 5 cm
        • specificity for excluding an AAA was 0.64
    • the painful aneurysm will be tender to firm pressure but there will only be guarding and generalised tenderness if the aneurysm has leaked
    • aneurysm mass will be fusiform - unless the iliac arteries are involved when it will be bilobed - and expansile
    • the palpating hands are moved outwards instead of simply upwards which occurs in thin people with normal aortas
  • signs such as xanthelasma and arcus may be present. Attention should be paid towards detecting carotid disease as this may require investigation and treatment as a priority.
  • if the aneurysm has bled then there may be signs of blood loss e.g - flank ecchymosis (Grey Turner sign)
  • examine femoral/popliteal pulses and pedal (dorsalis pedis or posterior tibial) pulses to identify any associated aneurysm (femoral/popliteal) or occlusive disease (1,2,3)

Reference:


Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.