• Risk Factors: Smoking, HTN, Atherosclerosis, Family Hx, Male gender, COPD

• Symptoms: Mostly asymptomatic, but most common presenting symptom is abdominal pain or flank pain.

• Signs: Pulsatile mass in mid left abdomen, Bounding pulses

• Dx: Abdominal aortic diameter greater than 1.5 baseline or >3cm

• Screening: routine screening is recommended in Men 65 to 75 years of age if any history of smoking more than 100 cigarettes/lifetime, but not in women unrelated to smoking Hx. Imaging choice is Ultrasound and if it is limited secondary to obesity or bloating: CT of Abdomen.

Between 3-4.4cm, patient will get yearly ultrasounds. If 4.5-5cm, then every 6 months and if >5, every 3 months.

• Management: surgery is indicated if it is symptomatic or its diameter >5.5 cm or has had more than 0.6-0.8 cm enlargement in 12 months.

• Prognosis: If it is ruptured, mortality can be as high as 90%. If repaired electively: 60% five year survival

• Pearls: Patient needs to be started on Beta-blockers before surgery. (Last edit:1/09/2010)