Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with sudden onset of severe, tearing abdominal and/or back pain radiating to the flank or groin. Associated with 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 exam demonstrates a pulsatile, expansile mass, often tender to palpation. Signs of retroperitoneal hemorrhage may include flank ecchymosis (Grey Turner sign) or periumbilical ecchymosis (Cullen sign).
Treatment Protocol
Immediate activation of vascular surgery and ICU teams. Strict hemodynamic stabilization (permissive hypotension). Large-bore IV access, fluid resuscitation, and blood product transfusion. Urgent surgical repair (open or EVAR) as indicated by anatomical findings and clinical stability.