Ruptured abdominal aortic aneurysm

Case contributed by Dr J. Ray Ballinger

Presentation

Severe right back pain; hemoglobin = 8.

Patient Data

Age: 71 years
Gender: Male

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.

Case 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.

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Case information

rID: 23660
Case created: 30th Jun 2013
Last edited: 18th Sep 2015
System: Vascular
Inclusion in quiz mode: Included

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