Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with sudden onset of severe, tearing abdominal and/or flank pain radiating to the back. Associated symptoms include syncope, hypotension, and signs of hemodynamic instability. History significant for known AAA, hypertension, and smoking.
Clinical Examination Findings
Patient appears diaphoretic, pale, and in acute distress. Vital signs reveal tachycardia and hypotension. Abdominal examination demonstrates a pulsatile, expansile mass, often with associated tenderness. Presence of Grey Turnerโs or Cullenโs sign may be noted. Peripheral pulses may be diminished or asymmetric.
Treatment Protocol
Immediate resuscitation initiated with large-bore IV access, fluid resuscitation, and blood product transfusion (per massive transfusion protocol). Emergent surgical consultation for open repair or endovascular aneurysm repair (EVAR). Strict blood pressure control (permissive hypotension) until surgical intervention.