Inflammatory AAA

 Q: All of the following are associated with inflammatory abdominal aortic aneurysm (AAA) EXCEPT? 

A) chronic abdominal pain 

B) weight loss 

C) elevated ESR 

D) Increased incidence of rupture

Answer: D

If following triad is present with AAA, it highly suggests inflammatory AAA

• chronic abdominal pain
• weight loss
• elevated ESR

There is an interesting paradox in inflammatory AAA. Although there are more chances to be symptomatic when compared to the same size non-inflammatory AAA, the chance of actual rupture is low.

Said that, all symptomatic AAA require repair irrespective of size.

#surgical-critical-care

References:

1. Tang T, Boyle JR, Dixon AK, Varty K. Inflammatory abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2005 Apr;29(4):353-62. doi: 10.1016/j.ejvs.2004.12.009. PMID: 15749035.

2. Lindblad B, Almgren B, Bergqvist D, et al. Abdominal aortic aneurysm with perianeurysmal fibrosis: experience from 11 Swedish vascular centers. J Vasc Surg 1991; 13:231. 

3. Hellmann DB, Grand DJ, Freischlag JA. Inflammatory abdominal aortic aneurysm. JAMA. 2007 Jan 24;297(4):395-400. doi: 10.1001/jama.297.4.395. PMID: 17244836.