Abdominal Aortic Aneurysm

ABDOMINAL AORTIC ANEURYSM (AAA) AAAs are present in 5% of men aged over 60 years and 80% are confined to the infrarenal segment.  1. COMMON PRESENTATIONS OF AAA : A. INCIDENTAL On physical examination, plain x-ray or, most commonly, abdominal ultrasound B. PAIN In the central abdomen, back, loin, iliac fossa or groin  C. THROMBOEMBOLIC COMPLICATIONS  Thrombus within the aneurysm sac may be a source of emboli to the lower limbs D. COMPRESSION Surrounding structures such as the duodenum ( obstruction and vomiting ) and the inferior vena cava ( oedema and deep vein thrombosis )  E. RUPTURE Into the retroperitoneum, the peritoneal cavity or surrounding structures ( most commonly the inferior vena cava, leading to an aortocaval fistula ) 2. MANAGEMENT Until an asymptomatic AAA has reached a maximum of 5.5 cm in diameter, the risks of surgery generally outweigh the risks of rupture.  3. POPULATION SCREENING AND PREVENTION OF RUPTURED AAA "Ultrasound screening for AAA ...