Diagnosis of Abdominal Aortic Aneurysm by Abdominal Palpation

Abdominal palpation may have moderate sensitivity for detecting an abdominal aortic aneurysm large enough to be referred to surgery, but palpation cannot be used to exclude AAA, especially if rupture is a possibility. Level of evidence: "C"

A systematic review 1 including 9 studies (n=551) on abdominal palpation for ruptured abdominal aortic aneurysm (AAA) and 15 studies (n=2955) on abdominal palpation for asymptomatic AAA was abstracted in DARE. The sensitivity of palpation for ruptured AAA ranged from 51% to 100%, and the sensitivity of palpation for asymptomatic AAA ranged from 29% for AAAs of 3.0 to 3.9cm in diameter to 76% for AAAs 5.0 cm or greater. Positive and negative likelihood ratios when using a cut-off point of 3.0cm or greater were 12.0 and 0.72, and using a cut-off point of 4.0cm or greater they were 15.6 and 0.51. The positive predictive value of palpation for AAA of 3.0cm or greater was 43%.

References

Lederle FA, Simel DL. The rational clinical examination. Does this patient have abdominal aortic aneurysm? . JAMA 1999 Jan 6;281(1):77-82. [PubMed][DARE]

Primary/Secondary Keywords

Surgery
Cardiology
aortic aneurysm
palpation
Internal medicine
Thoracic surgery
Diagnosis
Abdominal aortic aneurysm

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Evidence summaries

Diagnosis of Abdominal Aortic Aneurysm by Abdominal Palpation

References