A practical approach to the diagnosis of abdominal aortic aneurysms.

In this study 217 patients with proved abdominal aortic aneurysm were reviewed and the diagnostic accuracy of ultrasonography was assessed in comparison with physical examination, plain abdominal roentgenography, and aortography for the evaluation of patients with a suspected abdominal aortic aneurysm. Ultrasonography is most accurate in detecting an aneurysm and in defining the size of the aneurysm. Routine aortography to evaluate the renal and iliac artery is not justified in the preoperative evaluation of patients with an abdominal aneurysm since the renal artery infrequently is involved by the aneurysmal process (3.7 percent) and the surgical results are consistently successful in those patients with renal and/or iliac artery involvement. If preoperatively needed, the renal status can be evaluated accurately with an isotope renogram combined with photoscan of the kidney. A practical approach to the diagnosis of pulsatile abdominal masses is proposed.