A patient with an abdominal aortic aneurysm may or may not present with symptoms depending on whether it has ruptured or if there are complications.
Unruptured abdominal aortic aneurysm:
(1) usually asymptomatic
(2) may result in chronic, vague abdominal, back or flank pain
Complications of an unruptured aneurysm:
(1) ureterohydronephrosis
An aneurysm with impending rupture may present as severe lumbar pain.
Ruptured aneurysm may present with:
(1) sudden onset of pain in mid-abdomen or flank, with radiation into scrotum if male
(2) hypotension and shock
(3) pulsatile abdominal mass
Point of Aortic Rupture |
Site of Hemorrhage |
Outcome |
anterolateral wall |
peritoneal cavity |
collapse and death |
posterolateral wall |
retroperitoneum |
biphasic rupture or chronic occlusion |
Biphasic rupture involves:
(1) a small tear with a small amount of bleeding
(2) a stable period of several hours
(3) occurrence of a larger tear with hypotension and shock
Infrequent complications of a ruptured aneurysm:
(1) aortoduodenal fistula
(2) aortocaval fistula
Specialty: Cardiology