Clinical Characteristics of the Abdominal Aortic Aneurysm

ABSTRACT

PURPOSE: In old age, abdominal aortic aneurysm (AAA) is not a rare disease and potentially fatal. Also, there has been a lack of concern for this disease in the emergency department. Our study investigated the clinical characteristics of AAAs seen in the emergency center to assess the needs of the diagnostic approach to this disease in the emergency center. METHODS: Eighty patients with an AAA between Jan. 1995 and Jul. 2002 were enrolled. Data were obtained from a retrospective review of medical records. We analyzed the clinical characteristics of the AAA on the basis of the patient 's age and sex, risk factors, presenting symptoms and signs, physical findings, diagnostic tools, and findings. RESULTS: AAAs were predominant in males (82.5%). A smoking history (57.5%), old age over 65 (71.3%) and hypertension (50.0%) were the most common risk factors. In this study, the initial diagnosis of a AAA was mostly determined by the existence of a pulsating abdominal mass, and the overall sensitivity of a pulsating abdominal mass was 57.5%. Although the most common presenting symptom was abdominal pain(51.3%), about one third of the patients had no subjective symptoms. Twenty-one of the patients had a ruptured AAA at the time of diagnosis. There was no remarkable difference in the incidence of large AAA (> 5 cm) or ruptured AAA between elderly (> 65years) and the young (< 65 years). CONCLUSION: Because of the absence or vagueness of symptoms and signs, an AAA might be initially excluded without a careful examination. For the early detection and prevention of a ruptured AAA, emergency medical doctors should carefully evaluate and assess patients with risk factors even though they have non-specific symptoms of the gastrointestinal or urinary system.