TY  - JOUR
T1  - DIagnosing abdominal aortic aneurysm
AU  - Callis JT
Y1  - 1999/06/02
N1  - 10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602
JO  - JAMA
SP  - 1989
EP  - 1989
VL  - 281
IS  - 21
N2  - 
To the Editor: The article by Drs Lederle and
Simel1 brings to the clinician's attention the serious
nature of abdominal aortic aneurysms (AAAs). While the article will
serve as a valuable reference for clinicians, their last sentence must
be disputed. When a ruptured AAA is suspected, imaging studies such as
ultrasonography or computed tomography should not be performed. When a
patient presents to the emergency department or a physician's office
with hypotension, a pulsatile abdominal mass, and associated flank or
abdominal pain, the patient should be taken directly to the operating
room for exploration and repair of a ruptured AAA. Delaying operation
with imaging studies only allows the patient's condition to become
more unstable. Patients may die as a result of delay while awaiting
preoperative studies. It has always been my contention that more
patients will die of an AAA on the table of a computed tomography
scanner than will die on the operating table. It is better to treat a
nonruptured aneurysm as an emergency than to treat a ruptured aneurysm
electively.

SN  - 0098-7484
M3  - doi: 10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602
UR  - http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602
ER  -