A 65-year-old heavy smoker is coming for a general examination..

الشرح

Core Concept: Screening for Abdominal Aortic Aneurysm (AAA) in high-risk populations based on age and smoking history.

Clinical Presentation:

• Typically asymptomatic until expansion or rupture (sudden severe abdominal/back pain, pulsatile mass, hypotension).
• Complications: Rupture leading to massive hemorrhage, shock, and death.

Diagnosis:

• First-line & Gold standard: One-time screening with abdominal ultrasound, which is highly sensitive and specific.

Management:

• Acute: Emergent surgical or endovascular repair (EVAR) if ruptured or symptomatic.
• Long-term: Surveillance with serial ultrasounds for small aneurysms; elective repair is indicated if the diameter exceeds 5.5 cm or expands rapidly (>0.5 cm in 6 months). The USPSTF recommends one-time ultrasound screening for AAA in men aged 65-75 who have ever smoked.