Case 1-2018: A 77-Year-Old Woman with Abdominal Pain, Weakness and Pulsatile Abdominal Region

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Zahra Farahani Mehrdad Taghipour Mohammad Moslemi


Abdominal aortic aneurysm refers to abdominal aortic with diameter of 3.0 cm or more (1). It is an unusual cause of abdominal and sometimes low back pain (2). Age older than 65 years, family history of  aortic aneurysm, smoking, and male sex are the main risk factors of this vascular complication (3).

A 77-year-old woman was referred to Besat hospital with epigastric and preumbilical pain of six weeks period. The pain was described as a dull achy sensation with no radiation and precipitation. There was no history of fainting and headache. She had dizziness to some extent. Defication or urinary dysfunction was not reported.

The patient's medical history was notable for cerebrovascular accident, hysterectomy and hypertension, which was well controlled with medical therapy. Current medications include: Nitrocontin, acetylsalicylic acid (ASA), Amlodipine and Atenolol. The patient was a nonsmoker and had no family history of connective tissue disease.

The physical examination revealed a blood pressure of 110/60 mm Hg. Head and neck examination revealed normal jugular vein pressure and no cervical and supraclavicular lymphadenopathy. In examination of fine, nondistent, gardless abdominal a pulsatile, nontender mass was palpated in left side of the umblia. A bruit or thrill was not detected on auscultation.

Edema, clubbing and cyanosis were not while sensorial and motor examinations of Extremities were normal. detected. All peripheral pulses were palpated with regular pattern.

Endoscopy, abdominal sonography and Color Doppler Sonography were ordered as radiologic examinations. The abdominal sonography revealed a pulsatile mass of 102mm by 113 mm in mid abdomen.

The patient underwent a successful open repair for abdominal aortic aneurysm with placement of a graft. During surgery, there was no evidence of rupture or superimposed infection. The patient is now alive.

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