UMEM Educational Pearls

Category: Vascular

Title: The Great Masquerader....AAA

Keywords: AAA, aneurysm (PubMed Search)

Posted: 2/12/2008 by Rob Rogers, MD (Updated: 2/18/2020)
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AAA...be afraid, be very afraid

Abdominal Aortic Aneurysm (AAA)  is known as the great masquerader in the elderly for good reason....

  • May look EXACTLY like a kidney stone
  • May cause vague abdominal and/or back pain....probably one of the reasons we scan older folks with abdominal pain. Presentations of AAA in the older patient may not be impressive!
  • May be associated with the "blue toe syndrome" (where mural thrombus flips distally and occludes small vessels in the feet and toes)
  • A pulsatile mass is frequently absent
  • 10% of urology referrals for older (>65) patients with suspected kidney stones result in a diagnosis of AAA