42 Abdominal aortic aneurysm Fig. 42.1A This radiograph demonstrates a calcified abdominal aortic aneurysm (AAA). The psoas shadow is lost on the left, suggesting a rupture. Background AAA is a common cause of death in elderly patients, with men being affected more than women. The overall mortality is about 50% in ruptured aneurysm and many die before reaching hospital. The best predictor of rupture is maximum aneurysm diameter: as this increases, the risk of rupture increases. Aneurysms above 5 cm in diameter have a high risk of rupture – those measuring 5–6 cm have a 3–15% annual risk, whereas those over 8 cm have a 30–50% risk. Always look at previous imaging if available when this diagnosis is suspected or made. Plain radiography is NOT the first investigation to request if this diagnosis is suspected, as it is not very sensitive or specific for the presence of an AAA. However, many patients presenting with abdominal pain have an AXR performed as part of their investigative work-up. When interpreting any plain AXR, the presence of a calcified AAA should always be checked for. If the features are present on the radiograph (often unexpectedly), immediate action is required. Think of this diagnosis in every patient presenting with abdominal pain. It is a diagnosis not to be missed, and the presenting features (see below) are rather non-specific. You may save a patient’s life. Clinical features Symptoms Unruptured • Can be asymptomatic (up to 75%) • Back pain. Ruptured • Severe, sudden-onset abdominal and back pain • Syncope Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Large bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Abdominal aortic aneurysm Full access? Get Clinical Tree
42 Abdominal aortic aneurysm Fig. 42.1A This radiograph demonstrates a calcified abdominal aortic aneurysm (AAA). The psoas shadow is lost on the left, suggesting a rupture. Background AAA is a common cause of death in elderly patients, with men being affected more than women. The overall mortality is about 50% in ruptured aneurysm and many die before reaching hospital. The best predictor of rupture is maximum aneurysm diameter: as this increases, the risk of rupture increases. Aneurysms above 5 cm in diameter have a high risk of rupture – those measuring 5–6 cm have a 3–15% annual risk, whereas those over 8 cm have a 30–50% risk. Always look at previous imaging if available when this diagnosis is suspected or made. Plain radiography is NOT the first investigation to request if this diagnosis is suspected, as it is not very sensitive or specific for the presence of an AAA. However, many patients presenting with abdominal pain have an AXR performed as part of their investigative work-up. When interpreting any plain AXR, the presence of a calcified AAA should always be checked for. If the features are present on the radiograph (often unexpectedly), immediate action is required. Think of this diagnosis in every patient presenting with abdominal pain. It is a diagnosis not to be missed, and the presenting features (see below) are rather non-specific. You may save a patient’s life. Clinical features Symptoms Unruptured • Can be asymptomatic (up to 75%) • Back pain. Ruptured • Severe, sudden-onset abdominal and back pain • Syncope Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related posts: Permanent pacemakers Gastric outlet obstruction Caecal volvulus Large bowel obstruction Brodie’s abscess Slipped upper femoral epiphysis Stay updated, free articles. Join our Telegram channel Join Tags: On-Call X-Rays Made Easy Aug 20, 2016 | Posted by admin in ULTRASONOGRAPHY | Comments Off on Abdominal aortic aneurysm Full access? Get Clinical Tree
