Does This Patient Have Abdominal Aortic Aneurysm?

摘要: In the physical examination of abdominal aortic aneurysm (AAA), only maneuver demonstrated value is palpation to detect abnormal widening pulsation. Palpation AAA appears to be safe and has not been reported precipitate rupture. The best evidence on accuracy palpation comes from 15 studies patients previously known have AAA who were screened with both ultrasound. When results these studies are pooled, sensitivity increases significantly with diameter (P<.001), ranging 29% for AAAs 3.0 3.9 cm 50% for 4.0 4.9 76% for 5.0 or greater. Positive negative likelihood ratios with 95% confidence intervals (CIs) using a cutoff point of 3.0 greater 12.0 (95% CI, 7.4-19.5) 0.72 CI, 0.65-0.81), respectively, 15.6 (95% 8.6-28.5) 0.51 0.38-0.67). The positive predictive in was 43%. Limited data suggest that obesity decreases the palpation. Abdominal specifically directed at measuring width moderate detecting an AAA that would large enough referred surgery but cannot be relied exclude AAA, especially if rupture a possibility.