Ruptured Abdominal Aortic Aneurysm

Ray Ballinger, MD, PhD

Straub Clinic and Hospital

rballinger at straub.net

Abstract

71 y/o male with severe rt back pain

Keywords

abdomen all ct aorta aneurysm

History

71 y/o male with severe rt back pain; Hemoglobin = 8

Findings

An 8 cm juxta-renal abdominal aortic aneurysm is noted. Blood is noted along the right side of the aneurysm extending around Gerota's fascia. The renal arteries arise from the aneurysm

Diagnosis

Ruptured Abdominal Aortic Aneursm

Confirmation:

Surgery

Discussion

Abdominal aortic aneurysms (AAA) are most commonly from atherosclerotic disease and occur in over 5% of the US population over 60 years of age. Smoking, hypertension and connective tissue disorders are among the risk factors. Men are more frequent than women. Only 20% of the cases present with a rupture. Most are detected incidentally. Mortality from rupture approaches 90% with involvement of the renal arteries particularly ominous. Generally AAA over 5 cm in size are electively repaired, either surgically or by endograft placement. The risk of rupture for a 5 cm aneurysm over the following year is 6-7% compared to the 3-5% morbidity and mortality from surgery. Endograft placement in selected patients appears to have lower morbidity and mortality than surgical repair.