Diagnostics

The diagnosis of AAA is confirmed by imaging showing aortic diameter > 3 cm. Unstable patients should be taken directly to the OR for emergency surgery if ruptured AAA is suspected (see ruptured AAA). There are no laboratory findings specific to AAA.

• Indications

  • Best initial and confirmatory test in:

    • Asymptomatic patients

    • Patients with abdominal pain and no known AAA or risk factors for AAA

  • To determine the presence, size, and extent of an aneurysm

  • Screening and surveillance

• Formal ultrasound

  • Obtain longitudinal and transverse views for:

    • Proximal, mid, and distal abdominal aorta

    • Both proximal common iliac arteries

  • Obtain AP dimension measurements of the greatest diameters of each vessel.

  • See “POCUS for suspected AAA” for the point-of-care imaging technique and findings.

• Supportive findings

  • Dilatation of the aorta ≥ 3 cm

  • Thrombus may be present

Refer the patient for treatment immediately!

• Indications

  • Imaging modality of choice in symptomatic patients and for preintervention planning

  • To help confirm the diagnosis when ultrasound is not possible in asymptomatic patients

  • More detailed evaluation of the location, size, and extent of the aneurysm, involvement of branch vessels, and presence of thrombus or rupture

• Supportive findings

  • Dilatation of the aorta ≥ 3 cm and, possibly, branch vessels

  • Reduced distribution of vasa vasorum may be seen. [10]

  • Thrombus may also be present