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Abdominal Aortic Aneurysm, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Focal dilation of the aortic wall with an increase in diameter by at least 50% (>3 cm).

  • 95% are infrarenal.

  • Rapid expansion or rupture causes symptoms.

  • Rupture can occur into the int...

Diagnosis

Signs and Symptoms

History

  • Abdominal, back, or flank pain:

    • Vague, dull quality

    • Constant, throbbing, or colicky

    • Acute, severe, constant

    • Radiates to chest, thigh, inguinal area, or scrotum

    • Flank pain...

Treatment

Pre-Hospital

  • Establish 2 large-bore IV lines

  • Rapid transport to the nearest facility with surgical backup

  • Alert ED staff as soon as possible to prepare the following:

    • Operating room

    • Universal don...

Follow-Up

Disposition

Admission Criteria

All patients with symptomatic AAA require emergent surgical intervention and admission. 

Discharge Criteria

Asymptomatic patients only 

Follow-Up Recommendations

  • Clo...

Pearls and Pitfalls

  • AAA should be on the differential for any patient presenting with pain in the abdomen, back, or flank.

  • Symptomatic AAA requires immediate treatment. Do not delay definitive care for...

Additional Reading

  • Bentz  S, Jones  J. Accuracy of emergency department ultrasound in detecting abdominal aortic aneurysm. Emerg Med J.  2006;23(10):803–804.

  • Choke  E, Vijaynagar  B, Thompson  J, ...

Codes

ICD9

  • 441.3 Abdominal aneurysm, ruptured

  • 441.4 Abdominal aneurysm without mention of rupture

ICD10

  • I71.3 Abdominal aortic aneurysm, ruptured

  • I71.4 Abdominal aortic aneurysm, without rupture

SNOMED

  • 23398...

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