Abdominal Aortic Aneurysm

Infrarenal aortic diameter >30mm, with annual risk of rupture proportionate to diameter:

Epidemiology and Risk Factors

Risk factors:

  • Age
  • Male

Pathophysiology

Aetiology

Clinical Manifestations

Diagnostic Approach and DDx

Investigations

Radiology:

  • CT
  • Ultrasound
    Used for high-risk population (men >65) screening in some nations.

Management

Resuscitation:

Specific therapy:

  • Pharmacological
  • Procedural
    • EVAR
      • ↓ Perioperative mortality (~1%) compared with open repair
    • Open repair
      • ~3% mortality
  • Physical

Supportive care:

Disposition:

Marginal and Ineffective Therapies

Anaesthetic Considerations

Complications

  • C
    • Aneurysm rupture
      • Sudden onset of:
        • Pain
          Back, abdominal.
        • Tenderness
        • Hypovolaemic shock
      • Highly fatal
        • 22% die prior to hospital
        • Overall ~60% mortality
      • CT appropriate if haemodynamically stable
      • EVAR may be appropriate

Prognosis

Key Studies

References

  1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.