What is the significance of the pulsatile mass?
Of greatest concern in the assessment of a patient with a tender pulsatile abdominal mass is the possibility of a leaking or ruptured Abdominal Aortic Aneurysm (AAA). Other serious abdominal pathologies may demonstrate the same clinical signs but require entirely different treatments.
What is a differential diagnosis in aortic aneurysm?
An abdominal aortic aneurysm should be differentiated from other causes of abdominal pain such as acute cholecystitis, gastrointestinal bleeding, perforated peptic ulcer, ischemic bowel, nephrolithiasis, pyelonephritis, appendicitis, cholelithiasis, large bowel obstruction, small bowel obstruction, pancreatitis.
How is AAA diagnosed?
Tests to diagnose an abdominal aortic aneurysm include:
- Abdominal ultrasound. This is the most common test to diagnose abdominal aortic aneurysms.
- Abdominal CT scan. This painless test uses X-rays to create cross-sectional images of the structures inside the belly area.
- Abdominal MRI .
What causes pulsatile abdomen?
When you eat, your body puts in extra work to digest food and absorb energy and nutrients. To accomplish this, it pumps extra blood to your stomach and small intestine through your aorta. If you notice a pulse in your stomach after eating, it’s likely due to increased blood being pumped through your abdominal aorta.
What causes pulsatile abdominal mass?
Abdominal aortic aneurysms are the commonest cause of pulsatile tender epigastric masses but may be mimicked by other serious conditions. Objective clinical and imaging assessment is vital in ensuring appropriate management.
What is the differential diagnosis for abdominal aortic aneurysm?
Ruptured viscus, mesenteric ischemia, strangulated hernia, ruptured visceral artery aneurysms, acute cholecystitis, acute pancreatitis, ruptured hepatobiliary cancer, lymphoma, and diverticular abscess should be considered in the differential diagnosis of symptomatic AAA.
What is pulsating abdominal mass?
Abstract. Clinical palpation of a pulsating abdominal mass alerts the clinician to the presence of a possible abdominal aortic aneurysm (AAA). Generally an arterial aneurysm is defined as a localized arterial dilatation ≥50 % greater than the normal diameter.
What is abdominal aortic aneurysm screening?
Abdominal aortic aneurysm (AAA) screening is a way of checking if there’s a bulge or swelling in the aorta, the main blood vessel that runs from your heart down through your tummy. This bulge or swelling is called an abdominal aortic aneurysm, or AAA.
What is abdominal mass pulsation?
Which is the most common differential diagnosis of pulsatile upper abdominal mass?
We have summarised the differential diagnosis of a pulsatile upper abdominal mass in (Table 1). These mainly involve structures and viscera that lie in the epigastrium. By far the most common differential diagnosis is an aneurysm of abdominal aorta (fig. 3), rarely superior mesenteric artery [4].
Can a pulsatile upper abdominal mass be an aneurysm?
We have summarised the differential diagnosis of a pulsatile upper abdominal mass in (Table 1). These mainly involve structures and viscera that lie in the epigastrium. By far the most common differential diagnosis is an aneurysm of abdominal aorta (fig. 3), rarely superior mesenteric artery.
What to know about a tender pulsatile abdominal mass?
Of greatest concern in the assessment of a patient with a tender pulsatile abdominal mass is the possibility of a leaking or ruptured Abdominal Aortic Aneurysm (AAA). Other serious abdominal pathologies may demonstrate the same clinical signs but require entirely different treatments.
Do you need a CT scan for a pulsatile mass?
In patients with symptomatic pulsatile abdominal masses, and in the absence of hypovolemic shock, the preferred initial diagnostic study is abdominal CT scan. It is an accurate and safe procedure [7].