Abdominal aortic aneurysm (AAA) is often asymptomatic until complications such as rupture occur. AAAs are often incidentally detected during imaging for other disorders. Risk factors include old age, male gender, and smoking; there is an association with vascular disorders, hypertension, and hyperlipidemia. Once diagnosed, an AAA requires regular surveillance through imaging. Medical management includes addressing the risk factors, control of hypertension and hyperlipidemia, smoking cessation, and watchful waiting with surveillance. Elective surgery is recommended for aneurysms that continue to enlarge during surveillance or are larger than 5.5 cm. In the event of rupture, mortality is high in spite of emergency surgery. The USPSTF recommends one-time ultrasonographic screening for AAA in male ever smokers and aged 65-75. Ultrasonography is the preferred imaging modality for screening and surveillance.
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