Abdominal Aorta Aneurysm (AAA)

Lucky to see a case of abdominal aorta aneurysm(AAA)on Thursday but maybe not so lucky for that patient because in case of aneurysm rupture, the mortality is quite high. Managed to see and feel what is written on textbook--- pulsatile abdominal mass above the umbilicus. It amazed me! We saw the CT angiography with 3D reconstruction too. Wow, it is just so unbelievable that such a big aneurysm has developed in his abdomen and produces so many 'bends' or 'kinks'. The patient is going to have endovascular treatment---a stent graft will be placed into his abdominal aorta to prevent the rupture.



Risk factors:
smoking, hypertension, age over 70 years old, family history of AAA

Symptoms:
75% asymptomatic
in case of acute expansion or disruption of wall: pain(abdominal, back, flank pain), hypotension, pulsatile abdominal mass rarely partila intestinal obstruction, ureteric obstruction and hydronephrosis, GI bleeding(duodenal mucosal hemorrhage, aortoduodenal fistula), aortocaval fistula, distal embolisation(blue toe)

Diagnosis:
pulsatile abdominal mass, bruits on auscultation, abdominal USG, CT, MRI, Doppler

Treatment:
smoking cessation, HTN control, DM control, hyperlipidemia control
surgery or endovascular options(stent graft)