Abdominal aortic aneurysm history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Hardik Patel, M.D.

Overview

Abdominal aortic aneurysms (AAA) are usually asymptomatic until they expand or rupture. Spontaneous abdominal pain in a patient with a pulsatile epigastric mass or a known AAA may signal a rupture into the retroperitoneum or leakage within the aneurysm wall. If a patient does develop symptoms, the risk of rupture is quite high, which is why symptoms are considered an indication for surgery. Pain is the most common symptomatic manifestation.

History and Symptoms

History

Given that smoking increases the risk of developing an abdominal aortic aneurysm (AAA), a smoking history should be obtained in elderly men. If a male over the age of 65 has a history of smoking, he should undergo ultrasonography to screen for an AAA.^[1]

Symptoms

Abdominal aortic aneurysms are usually asymptomatic until they expand or rupture. The following symptoms may be present:^[2]

- Abdominal pain, radiating to the back, flank, and groin
- Clammy skin
- Early satiety
- Flank pain
- Groin pain
- Lower back pain
- Nausea and vomiting
- Syncope

Associated Symptoms

Hematemesis (when associated with aortoenteric fistulas)
Lower extremity pain and discoloration (when associated with thromboembolization)
Melena (when associated with aortoenteric fistulas)^[3]
Urinary symptoms (when associated with ureteral obstruction)^[4]

References

↑ Isselbacher, Eric M. (2005). “Thoracic and Abdominal Aortic Aneurysms”. Circulation. 111 (6): 816–828. doi:10.1161/01.CIR.0000154569.08857.7A. ISSN 0009-7322.
↑ Ferri, Fred (2015). Ferri’s clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
↑ Ferri, Fred (2015). Ferri’s clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.
↑ Chaikof, EL.; Brewster, DC.; Dalman, RL.; Makaroun, MS.; Illig, KA.; Sicard, GA.; Timaran, CH.; Upchurch, GR.; Veith, FJ. (2009). “The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines”. J Vasc Surg. 50 (4 Suppl): S2–49. doi:10.1016/j.jvs.2009.07.002. PMID 19786250. Unknown parameter |month= ignored (help)

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[Isselbacher2005-1] Isselbacher, Eric M. (2005). “Thoracic and Abdominal Aortic Aneurysms”. Circulation. 111 (6): 816–828. doi:10.1161/01.CIR.0000154569.08857.7A. ISSN 0009-7322.

[2] Ferri, Fred (2015). Ferri’s clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.

[3] Ferri, Fred (2015). Ferri’s clinical advisor 2015 : 5 books in 1. Philadelphia, PA: Elsevier/Mosby. ISBN 978-0323083751.

[Chaikof-2009-4] Chaikof, EL.; Brewster, DC.; Dalman, RL.; Makaroun, MS.; Illig, KA.; Sicard, GA.; Timaran, CH.; Upchurch, GR.; Veith, FJ. (2009). “The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines”. J Vasc Surg. 50 (4 Suppl): S2–49. doi:10.1016/j.jvs.2009.07.002. PMID 19786250. Unknown parameter |month= ignored (help)

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