Clinical Presentation

Inflammatory abdominal aortic aneurysms occur predominantly in males in the 5th and 6th decades of life. The male to female ratio ranges from 15-6.5:1. Risk factors for atherosclerosis and the association with coronary artery (46-55%) and peripheral vascular disease (24%) occur with the same frequency as in patients with noninflammatory aneurysms. Nitecki et al has reported that patients with IAAA were more likely (17% versus 1.5%) to have a family history of aneurysms and currently be smoking cigarettes.

The clinical triad of chronic abdominal pain, weight loss, and an elevated eryth-rocyte sedimentation rate (ESR) in a patient with an abdominal aortic aneurysm is highly suggestive of an inflammatory aneurysm. Abdominal, flank, or back pain is present in up to 83% of patients with no ruptured IAAA compared to 14% of patients with noninflammatory aneurysms. Anorexia and weight loss occurs in 10-41% of patients with IAAA compared to 7-10% of those with AAA. The erythrocyte sedimentation rate is elevated in 40-88% of patients. The occurrence of fever and leukocytosis is quite variable (Table 16.1).

The most consistent finding on physical examination is the presence of a tender pulsatile mass. However, detection of a pulsatile mass is dependent on the size of the aneurysm as well as patient body habitus.

Table 16.1. Comparison of the frequency of symptoms between patients with IAAA and AAA

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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