Abdominal aortic aneurysms: clinical diagnosis and management

Abstract

Objective: To review the presentation, diagnosis and management of aortic aneurysms. Case reports and a brief topic review are presented.

Clinical features: Three cases of aneurysm that were diagnosed in a chiropractic office are discussed. An aneurysm is defined as an abnormal dilation of the aorta as a result of atherosclerosis, genetic predisposition and/or acquired biochemical alterations in the wall of the aorta. The "classic triad," hypotension, back pain and a pulsatile abdominal mass are present in only 50% of those people with ruptured abdominal aortic aneurysms (AAA). Large unruptured aneurysms are quite often asymptomatic and are often found incidentally on physical or X-ray examination. History, palpation, auscultation and imaging are all helpful in diagnosing AAAs, and all are readily available in a chiropractic office.

Intervention and outcome: Surgical intervention is generally considered appropriate in AAAs > 5 cm in diameter. All patients recovered after surgical repair of the aneurysm.

Conclusion: Chiropractors can perform simple diagnostic procedures to differentially diagnosis and screen for AAAs. Such screening measures may yield a statistical decrease in deaths caused by rupture of aortic aneurysms.