Elsevier

Surgery

Volume 117, Issue 4, April 1995, Pages 454-457
Surgery

Role of physical examination in detection of abdominal aortic aneurysms

https://doi.org/10.1016/S0039-6060(05)80067-4Get rights and content

Background. Early detection of asymptomatic abdominal aortic aneurysms (AAAs) has been advocated to decrease the high mortality rate of ruptured AAAs. The purpose of this study was to document how AAAs were detected, whether AAAs not detected on physical examination (PE) were palpable, and what factors precluded detection by PE.

Methods. Two hundred forty-three patients undergoing elective infrarenal AAA repair at a Veterans Affairs, county, or university hospital during a 10-year period were analyzed retrospectively. The method of initial detection of the AAA, size of the AAA at initial detection and before repair, and whether the AAA was palpable on preoperative PE were recorded, and the body mass index [BMI; weight in kg/(height in meters)2] was calculated. Obese patients were defined with MBI of greater than 85th percentile.

Results. Only 93 (38%) patients had their AAAs initially detected by PE; the remainder (62%) were found incidentally on radiologic examinations performed for other indications. Patients with p<0.001), but there was no difference in AAA size (PE, 5.8±1.6 cm; incidental, 5.5±1.9 cm, not significant). Forty-three percent of patients with AAAs detected on radiologic examination had palpable AAAs and should have been detected on PE. Overall, 55 (23%) AAAs were not palpable on preoperative PE, even when the diagnosis was known. Obese patients had only 15% of AAAs detected by PE, and only 33% were palpable.

Conclusions. AAAs are underdiagnosed by PE, especially in obese persons. More widespread abdominal examination to detect a widened aortic pulse would improve detection of AAAs.

References (20)

There are more references available in the full text version of this article.

Cited by (56)

  • Abdominal aortic repair in women: Criteria for repair and device selection

    2021, Vascular Disease in Women: An Overview of the Literature and Treatment Recommendations
  • Effects of blood viscoelasticity on pulsatile hemodynamics in arterial aneurysms

    2020, Journal of Non-Newtonian Fluid Mechanics
    Citation Excerpt :

    The results showed that the elastic properties lead to considerable differences in the velocity field in transient flow conditions. Aneurysms are the permanent dilations of the artery, they are mostly asymptomatic and their rupture is associated with high mortality rates [29,30]. The size of the aneurysm is commonly used as the rupture risk indicator; however, the studies show that the hemodynamic factors and risk indicators based on the wall shear stress are better to indicate rupture risk [3,31].

  • Computed Tomography for the Diagnosis and Management of Abdominal Aortic Aneurysms

    2011, Surgical Clinics of North America
    Citation Excerpt :

    With the increasing use of CT imaging in the diagnosis and treatment of abdominal disorders, the incidental finding of AAA is more commonplace. Chervu and colleagues1 reviewed 243 patients undergoing elective AAA repair, and found that 38% of AAAs were found initially on physical examination whereas 62% were found incidentally by radiological examinations. Furthermore, AAAs become increasingly more common with age, as does a patient’s exposure to radiological imaging for diagnostic and other screening examinations.

  • Abdominal Aortic Aneurysms

    2023, Peripheral Arterial Disease Handbook
View all citing articles on Scopus
View full text