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CR - AAA (Clinical exam (listen for bruits (poor clinical sign, turbulent…
CR - AAA
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surgery indications
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must consider rupture risk, operative mortality + life expectancy (stents fail after 10 yrs so if life expectancy > 2yrs do open surgery)
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Symptoms
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rupture (free, usually fatal, hypovolaemic shock, sudden epigastric/back pain)
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Tx
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open repair
incisions either
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retroperitoneal
preferred in a hostile abdo, inflamm, perivisceral AAA, horseshoe kidney
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1) proximal dissection, cross-clamping (distal + proximal), evacuation of haematoma
2) ligation of lumbar arts (come off back of aorta @ T4-6) + IMA (supplies large bowel) to preventing bleeding
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