Abdominal Aortic Aneurysms

Abdominal Aortic Aneurysms Lawsuits in Maryland

An abdominal aortic aneurysm is an abnormal enlargement or ballooning of the abdominal aorta, the large blood vessel supplying blood to the abdomen, pelvis and legs.  Approximately 1 in 25 persons over the age of 65 harbour an abdominal aortic aneurysm.  It has been reported that the prevalence has tripled over the past 30 years.  The United States Preventive Services Task Force recommends that all men who have ever smoked be screened at least once for abdominal aortic aneurysms between 65 and 75 years of age.

As many as 60% of cases of abdominal aortic aneurysms are incorrectly diagnosed by first-contact practitioners, leading to delays in surgery.  The best hope of survival is prompt diagnosis and treatment.   When an abdominal aortic aneurysm ruptures, complications which may arise include arterial embolism, heart attack, hypovolemic shock, kidney failure, and stroke.

Misdiagnosis of aortic aneurysms can cause severe injury and death.  Abdominal aortic aneurysms are the 14th leading cause of death in the US.  It is estimated that 4,500 deaths are attributed to an abdominal aortic aneurysm rupture in the US and an additional 1,400 deaths result from procedures to repair the aneurysm and prevent rupture.   

You can’t dilly-dally with this condition.  If the doctors don’t identify it quickly and get a patient to the operating room, there is a strong likelihood the patient will die.  This is outside the box for many doctors who – appropriately in most cases – like to test and test to get their diagnosis straight.   But if you wait around for a CT scan, you very well may lose the patient.

According to an article from the Annals of Vascular Surgery, they underscore how important it is to catch these aneurysms quick:  “All patients who had extensive diagnostic evaluation lasting more than 5 hours died… the only diagnostic procedure that definitively established aortic aneurysm in all cases was the CT scan.”   The failure to diagnose an abdominal aortic aneurysm is usually because the doctors confuse the condition with something else.  Often, doctors incorrectly misdiagnosis a kidney condition. 

If you think you have a potential wrongful death medical malpractice claim for someone you loved because the ER doctor or another doctor failed to diagnose an abdominal aortic aneurysm, call 800-553-8082 to discuss your potential case or get a free online case evaluation. 

Symptoms of Abdominal Aortic Aneurysms

Aneurysms are slow to develop, taking years, and are often asymptomatic (without symptoms).  Symptoms may develop suddenly if an aneurysm ruptures (tears open).  Symptoms of rupture include severe, sudden or constant pain in the abdomen or back that may radiate to the groin, legs or buttocks; clammy skin; nausea; vomiting; rapid heart rate; and shock.

Risk Factors for Abdominal Aortic Aneurysms

The precise cause of abdominal aortic aneurysms is not known. Risk factors that have been associated with abdominal aortic aneurysms include smoking, age, ethnicity (with Caucasians at highest risk), hypertension (high blood pressure), high cholesterol, emphysema, obesity and genetic factors.  Abdominal aortic aneurysms are more prevalent in men over the age of 60 with one or more of the previously mentioned risk factors. But these tragedy can hit anyone.

Diagnosis of Abdominal Aortic Aneurysms

Abdominal examinations and evaluation of pulses and feeling in ones legs are often the first step in diagnosing aortic aneurysms.  Signs that may be found by the examining doctor may include a lump in the abdomen, pulsating sensation in the abdomen, or a stiff or rigid abdomen.   The problem could also be found in asymptomatic patients through ultrasound or CT scan of the abdomen, and these tests are performed as well in patients presenting with symptoms of abdominal aneurysms.  X-rays are generally not appropriate for diagnosis of abdominal aortic aneurysm rupture, as they do not show presence of blood; therefore, CT scans are usually performed.  Up to 87% of patients who make it to an emergency room are stable enough for a CT scan.  The delay in operation associated with CT scans has not been demonstrated to increase the rate of deaths, thus CT scans are the most appropriate test to ensure proper diagnosis and treatment of patients presenting to the emergency room with an abdominal aortic aneurysm.

Treatment and Outcomes

Open abdominal aneurysm repair will be performed in cases where internal bleeding from an aortic aneurysm occurs.  If the aneurysm is small and no symptoms are present, regular monitoring by ultrasound is often recommended to see if the aneurysm is enlarging.  In some cases surgery may be advised, usually in cases where the aneurysms are larger than 2 inches, or for rapidly growing aneurysms, with the goal being to perform the surgery prior to complications.

Misdiagnosis of Abdominal Aortic Aneurysms

The classic symptoms of abdominal or back pain, hypotension, and a pulsatile abdominal mass are absent in more than 60% of the cases of ruptured abdominal aortic aneurysms.  Misdiagnosis by emergency physicians is a serious concern.  Varied and nonspecific symptoms lead to erroneous diagnoses and cause significant delays in proper intervention.  Despite advances in definitive treatment and imaging, the only means of improving early detection and survival is a heightened awareness among emergency room doctors and referring general practitioners.

In a retrospective study of 152 patients at the University of North Carolina, 30% were initially misdiagnosed.  Misdiagnosis of abdominal aortic aneurysm rupture has been reported to occur at a rate as high as 60%.  The most common misdiagnoses were diverticulitis, gastrointestinal haemorrhage, and renal colic.  Patients most commonly presented with abdominal pain, shock, and back pain.  However, these symptoms were not found in all subjects, rather only 50-70% of patients presented with one or more of these symptoms, and only one quarter of the patients were found to have a pulsatile abdominal mass in misdiagnosed patients.

Atypical symptoms make it challenging to properly diagnose as symptoms may be similar to renal colic, diverticulitis, gastrointestinal perforation/hemorrhage, urinary tract infection, and spinal disease.  Abdominal aortic aneurysm rupture is generally not suspected in stable patients who present without any truncal pain or collapse, a mistake that can prove fatal. 

Mortality can be decreased if the aneurysm is correctly diagnosed and treated before shock develops.  Thus prompt and accurate diagnosis is imperative for proper treatment and the best chance for a favourable outcome.

Abdominal Aortic Aneurysms and Other Medical Malpractice Claims in Maryland

Aortic aneurysms and aortic dissections can usually be treated when properly diagnosed. But they are frequently missed by emergency room and primary care doctors and, too frequently become the subject of a wrongful death medical malpractice claim. If you think you have a potential wrongful death malpractice claim for someone you loved because a doctor failed to diagnose an abdominal aortic aneurysm, call 800-553-8082 to discuss your potential case or get a free no obligation case evaluation.