This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention.
Key points
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Acute aortic syndrome is a group of diagnoses, including aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. These have similar risk factors, including hypertension and dyslipidemia, as well as comparable presentations.
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Aortic aneurysm can be a precursor to dissection and rupture. Close surveillance and risk factor modification are key to prevention of aneurysm progression.
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Aortic endoleak and aortoenteric fistula can be either primary processes or, more commonly, a postoperative complication after aortic repair. Although some endoleaks can be managed conservatively, aortoenteric fistulas are surgical emergencies.
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