Abdominal aortic aneurysm history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

The vast majority of aneurysms are asymptomatic. Spontaneous abdominal pain in a patient with a pulsatile epigastric mass or a known AAA may signal rupture into the retroperitoneum or leakage within the aneurysm wall. If a patient does develop symptoms, the risk of rupture is quite high, which is why symptoms are considered an indication for surgery.

Symptoms

Possible symptoms include

• Low back pain
• Flank pain
• Abdominal pain
• Groin pain
• Pulsating abdominal mass

As most of the AAAs are asymptomatic, their presence is usually revealed during an abdominal examination for another reason - the most common being abdominal ultrasonography. A physician may also detect the presence of an AAA by abdominal palpation. Note that an aneurysmal aorta may appear normal on angiogram, due to thrombus within the sac.

• Many AAAs are detected incidentally during cardiac catheterizations, computed tomography (CT), or magnetic resonance imaging (MRI) performed for unrelated reasons.
• Up to 50% of AAAs can be recognized on plain roentgenograms as a calcified aneurysmal wall.

• • This could lead to rapid expansion or imminent rupture.

• Peripheral embolization to the lower extremities (common in popliteal artery aneurysms) is rare with AAAs.

  • Rarely in larger or unstable aneurysms, disseminated intravascular coagulopathy may develop.