RupturedAAA.png
CT of a ruptured AAA

Definition

An Abdominal Aortic Aneurysm (or AAA) is an enlargement of the abdominal section of the descending aorta which is >1.5 times the normal diameter.

Prevalence

4.7% in Caucasians [1]

Age

Increase prevalence with age [2]

Gender

More likely in males [3]

Ethnicity

More likely in Caucasians [4]

Risk Factors

[5]

Signs and Symptoms

[6]

Pathophysiology

  • Atherosclerotic plaque in the aorta cause inflammation, media degeneration and arterial wall thinning.
  • Atherosclerotic aortic aneurysms typically occur in the abdominal portion distal to the renal arteries
  • Can be saccular of fusiform
  • The risk of rupture depends on the size
  • AAA can lead to ischaemia of distal areas, embolism from atheroma or mural thrombus, impingement on adjacent structures, an abdominal mass or rupture into the peritoneal cavity or retroperitoneal leading to a potentially fatal haemorrhage.

Investigations

[7]

Diagnosis

Diagnosis is confirmed with imaging

Classification

Differentials to rule out

[8]

Treatment

[9]

Non-Pharmacological

  • Reduce Cardiovascular risk (prevention)

Pharmacological

  • Reduce Cardiovascular risk (prevention)

Surgical

  • Surgery

Management

[10]
If AAA is an incidental finding then it should be monitored every 6 to 12 months with ultrasound.

Complications

[11]
  • Rupture leading to death
  • Ureteric Obstruction

Prognosis

[12]
Most AAAs will ultimately progress to rupture. If rupture occurs the mortality is >90%

See Also

BMJ Best Practice - AAA

Citation

"RupturedAAA" by James Heilman, MD - Own work. Licensed under CC BY-SA 3.0 via Wikimedia Commons - http://commons.wikimedia.org/wiki/File:RupturedAAA.png#/media/File:RupturedAAA.png
  1. ^ http://www.ncbi.nlm.nih.gov/pubmed/19666232
  2. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  3. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  4. ^ http://www.ncbi.nlm.nih.gov/pubmed/19666232
  5. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  6. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  7. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  8. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  9. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  10. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  11. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html
  12. ^ http://bestpractice.bmj.com.ezp.lib.unimelb.edu.au/best-practice/monograph/145/highlights/overview.html