Abdominal aortic aneurysm physical examination: Difference between revisions
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====Auscultation==== | ====Auscultation==== | ||
The presence of an [[abdominal bruit]] is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or [[renal artery stenosis|renal arterial stenosis]] <ref name="Chaikof-2009">{{Cite journal | last1 = Chaikof | first1 = EL. | last2 = Brewster | first2 = DC. | last3 = Dalman | first3 = RL. | last4 = Makaroun | first4 = MS. | last5 = Illig | first5 = KA. | last6 = Sicard | first6 = GA. | last7 = Timaran | first7 = CH. | last8 = Upchurch | first8 = GR. | last9 = Veith | first9 = FJ. | title = The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. | journal = J Vasc Surg | volume = 50 | issue = 4 Suppl | pages = S2-49 | month = Oct | year = 2009 | doi = 10.1016/j.jvs.2009.07.002 | PMID = 19786250 }}</ref>. | The presence of an [[abdominal bruit]] is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or [[renal artery stenosis|renal arterial stenosis]] <ref name="Chaikof-2009">{{Cite journal | last1 = Chaikof | first1 = EL. | last2 = Brewster | first2 = DC. | last3 = Dalman | first3 = RL. | last4 = Makaroun | first4 = MS. | last5 = Illig | first5 = KA. | last6 = Sicard | first6 = GA. | last7 = Timaran | first7 = CH. | last8 = Upchurch | first8 = GR. | last9 = Veith | first9 = FJ. | title = The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. | journal = J Vasc Surg | volume = 50 | issue = 4 Suppl | pages = S2-49 | month = Oct | year = 2009 | doi = 10.1016/j.jvs.2009.07.002 | PMID = 19786250 }}</ref>. | ||
==Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations) : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines<ref name="pmid23473760">{{cite journal| author=Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss L et al.| title=Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=J Am Coll Cardiol | year= 2013 | volume= 61 | issue= 14 | pages= 1555-70 | pmid=23473760 | doi=10.1016/j.jacc.2013.01.004 | pmc=4492473 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23473760 }} </ref>== | |||
===Symptomatic Aortic or Iliac Aneurysms=== | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.'''In patients with the clinical triad of abdominal and/or back pain, a pulsatile abdominal mass, and hypotension, immediate surgical evaluation is indicated.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.'''In patients with symptomatic aortic aneurysms, repair is indicated regardless of diameter. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
|} | |||
==References== | ==References== | ||
Revision as of 13:05, 1 November 2016
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Abdominal Aortic Aneurysm Microchapters |
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Differentiating Abdominal Aortic Aneurysm from other Diseases |
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Abdominal aortic aneurysm physical examination On the Web |
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Directions to Hospitals Treating Abdominal aortic aneurysm physical examination |
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Risk calculators and risk factors for Abdominal aortic aneurysm physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Hardik Patel, M.D.
Overview
A physical examination has low sensitivity in the detection of small abdominal aortic aneurysms (29-61% for abdominal aortic aneurysms 3.0-3.9 cm in diameter), but has a sensitivity of 76-82% in the detection those abdominal aortic aneurysms that are 5.0 cm or larger that may warrant repair. It is easier to detect a pulsatile mass in thin patients and those who do not have tense abdomens. Contrary to popular belief, gentle palpation of abdominal aortic aneurysms is safe and does not precipitate a rupture.
Physical Examination
General
Vital Signs
The following may or may not be present:
Abdomen
Inspection
Flank ecchymosis (Grey Turner sign) may be present in cases of ruptured aneurysms due to retroperitoneal hemorrhage.
Palpation
A pulsating or non-pulsating abdominal mass may be palpable.
Auscultation
The presence of an abdominal bruit is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or renal arterial stenosis [1].
Management of Patients With Peripheral Artery Disease (Compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations) : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[2]
Symptomatic Aortic or Iliac Aneurysms
| Class I |
| "1.In patients with the clinical triad of abdominal and/or back pain, a pulsatile abdominal mass, and hypotension, immediate surgical evaluation is indicated.(Level of Evidence: B)" |
| "2.In patients with symptomatic aortic aneurysms, repair is indicated regardless of diameter. (Level of Evidence: C) " |
References
- ↑ Chaikof, EL.; Brewster, DC.; Dalman, RL.; Makaroun, MS.; Illig, KA.; Sicard, GA.; Timaran, CH.; Upchurch, GR.; Veith, FJ. (2009). "The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines". J Vasc Surg. 50 (4 Suppl): S2–49. doi:10.1016/j.jvs.2009.07.002. PMID 19786250. Unknown parameter
|month=ignored (help) - ↑ Rooke TW, Hirsch AT, Misra S, Sidawy AN, Beckman JA, Findeiss L; et al. (2013). "Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 61 (14): 1555–70. doi:10.1016/j.jacc.2013.01.004. PMC 4492473. PMID 23473760.