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June 2, 1999, Vol 281, No. 21 >

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Letters | June 2, 1999

Diagnosing Abdominal Aortic Aneurysm

George B. Friend, MD
JAMA. 1999;281(21):1989. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602.
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To the Editor: Drs Lederle and Simel1 state "the only physical examination maneuver of demonstrated value for the diagnosis of an AAA is abdominal palpation." This is not quite accurate. I have found that visual observation of the relaxed abdominal wall in medium and large AAAs often gives the examiner a sense of a pulsatile mass in the mid abdomen, especially if the clinician observes the abdominal wall somewhat tangentially from the patient's side, rather than from directly over the patient's abdomen. When this finding is demonstrated to medical students and residents, it is quite instructive for them to actually visualize the location of the pulsatile mass in the central abdomen.

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