Abdominal Aortic Aneurism:
How Do I Know If I Have One?

More Than 80% of Patients Experiencing a Ruptured Abdominal Aortic Aneurism Do So without Previous Diagnosis of the Condition.

Because of the deadly potential of an aneurism rupture, this is a frightening statistic. In fact the initial misdiagnosis rate of AAA is estimated to be 24-42%. How does this happen?

Simply put, many aneurisms develop to a dangerous size without being accompanied by symptoms. What we don’t know can’t hurt us, right? Unfortunately, not in this case.

When it comes to detecting an abdominal aortic aneurism, knowledge is power. There are a number of successful treatment options for aneurism removal. But to operate on an abdominal aortic aneurism requires that we are able to detect it first. Waiting for symptoms to appear is not a satisfactory plan of attack. 

It would be nice if there were a home abdominal aortic aneurism detection kit that we could purchase from late night infomercials. If it made Julian fries too, that would be even better.

I am afraid you will have to see your doctor on this one. But it is nice to know that your doctor has a number of options for detecting aneurisms. Among them are…

  • plain radiography
  • ultrasounds
  • CT scans
  • MRI
  • angiography

Let’s look at each of these in more detail.

Plain Radiographs

Plain radiographs (x-rays) are often obtained for patients complaining of abdominal discomfort – there sometimes are symptoms - before the possibility of an abdominal aortic aneurism has been considered.

X-rays often miss the presence of an AAA because calcification - the process by which organic tissue becomes hardened by a deposit of calcium salts - of the aortic wall is seen less than half the time. Because of this radiographs are not the best diagnostic tools for the detection of AAA.

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Ultrasounds are noninvasive and may be performed at the patient’s bedside. They tend to be sensitive and are able to detect free peritoneal blood - blood found in the smooth watery membrane which lines the cavity of the abdomen.

However, ultrasonography is limited in its ability to detect leakage or rupture of an abdominal aortic aneurism. It further cannot easily detect aneurisms that involve branch arteries or those behind or above the kidneys. Further, if the patient is obese or suffers from gas in the bowels the ultrasound will have difficulty locating an aneurism.

CT scans

CT scans - computed tomography – are special radiographic techniques that use computers to assimilate multiple X-ray images into a 2 dimensional cross-sectional image. They are very sophisticated and are nearly 100% effective in locating aneurisms.

Computed tomography has certain advantages over ultrasounds. It is more accurate in…

  • defining the size of an abdominal aortic aneurism
  • detecting the involvement of certain arteries
  • finding aneurisms in proximity to the kidneys

It is also not limited by obesity or the presence of abdominal gas and can detect hard to find aneurisms associated with the most posterior area of the abdominal cavity.

Spiral CT scans produce three-dimensional imaging of abdominal contents enhancing the ability to see aneurisms adjacent to certain organs or branch arteries.

CT scans are more cost prohibitive and require specially trained technicians that might not be readily available. However they can be very useful in determining aneurism treatments.


MRI - Magnetic Resonance Imaging - is a special imaging technique used to image internal structures of the body, particularly the soft tissues. An MRI image is often superior to a normal X-ray image. It uses the influence of a large magnet to polarize hydrogen atoms in the tissues and then monitors the summation of the spinning energies within living cells.

MRI images are very clear and are particularly good for…

  • soft tissue
  • brain
  • spinal cord
  • joints
  • abdomen

These scans may be used for detecting some cancers or for following their progress. For abdominal aortic aneurisms an MRI produces aorta imaging comparable to CT scanning and ultrasound without the patient having to be exposed to radiation and dyes. It often produces superior results in imaging branch arteries but can be less effective in discovering aneurisms close to the kidneys. The use of MRI is costly and requires a stable patient.


Angiography involves a radiographic technique using a radio-opaque - a substance that shows up on X-ray - contrast material by injecting it into a blood vessel for the purpose of identifying its anatomy on X-ray. This technique is used to image arteries in the…

  • brain
  • heart
  • kidneys
  • gastrointestinal tract
  • aorta
  • neck (carotids)
  • chest
  • limbs
  • pulmonary circuit

It is useful in determining the anatomy of an aorta especially in searching for a suspected aneurism behind or above the kidneys. It is also useful in diagnosing aneurisms that exist outside of the abdomen such as femoral and popliteal - located behind the knee - aneurisms.

The test is, however, invasive and expensive and is not recommended for routine use. Some of these detection methods can be a bit invasive and are certainly expensive. However, because of the high risk associated with some aneurisms you should not hesitate to undergo any test your doctor prescribes if he or she suspects you have an aneurism.

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