HTHSCI 1DT3 Lecture Notes - Lecture 7: Anuria, Bubbly, Connective Tissue Disease
26 Dec 2020
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Radiates to back or flanks (don"t dismiss as colic) 2 x large bore cannulae in each acf. Give fluid if shocked but keep sbp <100mmhg. Blood: fbc, u+e, clotting, amylase, xmatch 10u. Call vascular surgeon, anaesthetist and warn theatre. Take to theatre: clamp neck, insert dacron graft. If stable + dx uncertain: us or ct may be feasible. May back pain or umbilical pain radiating to groin. Won"t show true extent of aneurysm due to endoluminal thrombus. Useful to delineate relationship of renal arteries. Uk small aneurysm trial suggested that aaa <5. 5cm in maximum diameter can be monitored by us (/ct) Aim to treat aneurysm before it ruptures. Operate when risk of rupture > risk of surgery. No mortality by 5yrs due to fatal endograft failures. Evar not better than medical rx in unfit pts. Mass trial revealed 50% aneurysm-related mortality in males aged 65-74 screened c us. Uk men offered one-time us screen @ 65yrs.
