Abdominal aortic aneurysm physical examination

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Abdominal Aortic Aneurysm Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Hardik Patel, M.D.

Overview

Physical examination has a low sensitivity in the detection of small abdominal aortic aneurysms (29-61% for abdominal aortic aneurysms 3.0-3.9 cm in diameter) but has a sensitivity of 76-82% to detect those abdominal aortic aneurysms that are 5.0 cm or larger that may warrant repair. It is easier to detect a pulsatile mass in thin patients and those who do not have tense abdomens. Contrary to popular belief, gentle palpation of abdominal aortic aneurysms is safe, and does not precipitate rupture.

Physical Examination

General

Abdomen

  • Inspection

Flank ecchymosis (Grey Turner sign) may be present in cases of ruptured aneurysms due to retroperitoneal hemorrhage.

  • Palpation

A pulsating or non-pulsating abdominal mass may be palpable.

  • Auscultation

Abdominal bruit is nonspecific for a nonruptured aneurysm and can be present in cases of visceral or renal arterial stenosis.

References

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