ABDOMINAL AORTIC ANEURYSM

An abdominal aortic aneurysm (AAA) is a bulge in the main artery (aorta) in the abdomen. Many patients have AAA without symptoms and may be followed by their primary care physician until the AAA is large enough to warrant surgery. Patients come to the emergency room with symptoms of AAA when there is a rupture, or leak, of the aneurysm. This is a life-threatening emergency. Between 75 and 80 per cent of patients with a ruptured AAA die before they reach the hospital. Of the remainder, half will likely die even though they reach the hospital, and half may survive if the condition is promptly diagnosed and treated.

Risk factors include age (over 60), smoking, high blood pressure, family history of AAA, and a history of vascular disease. AAA occurs most often with men, but may also be found in women.

Any patient presenting to the emergency room with those risk factors, and symptoms which may include sudden onset of tenderness or pain in the abdomen or back, a pulsating sensation in the abdomen (not always present), nausea and vomiting. Frequently, a patient presenting to the emergency room with a ruptured AAA is mistakenly diagnosed with kidney stones or some other urologic condition. The failure of emergency room health care providers to include AAA in the list of possible causes of the patient’s symptoms, and to order tests such as a CT Scan or MRI to rule out the condition, may very well result in death.