Aortic Aneurysm, Abdominal

Bloated

Step 1: View clinicals

A 71 year old man presents with persistent lower back pain for one and a half months. The pain is dull and aching in nature and does not radiate. There is no history of recent trauma. His co-morbidities are well controlled hypertension for 15 years and ischemic heart disease for which coronary artery bypass grafting was performed 10 years ago. A full blood count and urinalysis are found to be normal.


Step 2: Order all relevant investigations

X-Ray lumbo-sacral spine

The x-ray appears normal

Ultrasound abdomen

The ultrasound scan shows a dilated infra-renal abdominal aorta with a maximum diameter of approximately 5.7cm.

Bone scintigraphy

The bone scan appears normal.

Autoimmune screen

ANA - negative ds-DNA - negative ENA - negative Rheumatoid factor - negative


Step 3: Select appropriate management

Anticoagulation
Antibiotics
Aneurysm repair
Chemotherapy


Score: ★★☆