Failure to Timely Diagnose Aortic Aneurysm

Evaluate breaches in the standard of care by using your particular face pattern to answer the questions below to determine whether or not there was a Failure to Timely Diagnose Aortic Aneurysm

Answer the following questions to find out if the standard of care was followed for your case.

  • With which of the following symptoms did the patient present? (Choose all that apply)
    Pain in the abdomen, back, or flank
    An awareness of an abdominal mass or fullness
    A sensation of abdominal pulsations
    None, discovered incidentally from imaging studies performed for other reasons
    Why is this important?
    Most abdominal aortic aneurysms cause no symptoms until they rupture. Patients may have vague symptoms such as slight pain in the abdomen, sharp pain in the back or flank; a sensation of fullness in the abdomen; or a sensation of abdominal pulsations.
    (2007) 25 ESURGO 8 344

  • Did the clinician order imaging to confirm a diagnosis of abdominal aortic aneurysm? Why is this important?
    Answer this question
    
Imaging studies increase the accuracy and aid in confirming the diagnosis of abdominal aortic aneurysm.

    (2007) 25 ESURGO 8 344 



  • With which of the following risk factors did the patient present? Why is this important?
    Answer this question
    
There are four significant risk factors that are associated with abdominal aortic aneurysm; gender, age, a history of cigarette smoking, and a family history of aneurysm.

    (2007) 2 EULTRC 3 437 



  • Was the patient provided a diagnosis other than that of an abdominal aortic aneurysm and discharged? Why is this important?
    Answer this question
    
The differential diagnosis of the acute onset of severe abdominal pain includes perforated ulcer, intestinal obstruction, acute pancreatitis, acute cholecystitis, and nephrolithiasis.

    (2008) 92 EMEDCN 3 627-647 



  • Did the clinician perform a physical examination? Why is this important?
    Answer this question
    
A complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's evaluation and enables the clinician to make the most judicious use of additional tests. It helps determine the value of incongruent and conflicting results that can emerge during the diagnostic process, and it can obviate the need for tests that are costly or expose the patient to discomfort or risk. The deep understanding of the patient that can be obtained only through the immediacy of the history and physical examination also plays a pivotal role in treatment decisions that must be addressed at various points throughout the patient's lifetime.

    Click here for additional information at MD Consult.com 



  • Was the patient referred to a vascular surgeon for surgical evaluation? Why is this important?
    Answer this question
    
Once priorities and goals have been agreed on, referral to the appropriate professionals must be made in a timely manner. To deliver care requires a coordinated approach that allows sharing of skills and expertise. The skills of members from all professional disciplines must be utilized to enable all patients to achieve their maximum potential.

    Click here for additional information at MD Consult.com 



  • Was an ultrasound performed? Why is this important?
    Answer this question
    
Ultrasound is the most commonly used screening modality for abdominal aortic aneurysm, with an accuracy of almost 100%.

    (2007) 2 EULTRC 3 437-453 



  • Was an urgent surgical evaluation performed? Why is this important?
    Answer this question
    
Aneurysm rupture calls for urgent surgical intervention.

    (2007) 25 ESURGO 8 344 



  • Did the clinician recommend an ultrasound? Why is this important?
    Answer this question
    
Ultrasound is the most commonly used screening modality for abdominal aortic aneurysm, with an accuracy of almost 100%.

    (2007) 2 EULTRC 3 437 



  • What was the result of the ultrasound? Why is this important?
    Answer this question
    
The size of the aneurysm guides the management and treatment necessary to contain the aneurysm and prevent it from rupture.

    (2007) 2 EULTRC 3 437 



  • Which of the following surgical repairs was performed? Why is this important?
    Answer this question
    
The conventional technique for repair of an aortic abdominal aneurysm has been the open laparotomy repair. Endovascular repair is an alternative for patients who are unsuitable for open repair.

    (2010) 21 EJVAIR 11 1632 



  • Did the clinician recommend elective repair to treat the abdominal aortic aneurysm? Why is this important?
    Answer this question
    
Elective surgery involves replacement with an aortic prosthesis and re-implantation of the visceral and intercostal arteries.

    (2007) 25 ESURGO 8 344-347 



  • Was surveillance imaging recommended? Why is this important?
    Answer this question
    
Surveillance monitoring may be via ultrasound or Computerized Tomography scanning.

    (2006) 47 JAMECC 6 1239 



  • Which of the following long-term complications did the patient experience? Why is this important?
    Answer this question
    
Graft infection can disrupt the anastomosis between native artery and graft, leading to leakage of blood and pseudo-aneurysm formation.

    Click here for additional information at ClinicalKey.com 



  • Did the aneurysm enlarge within a six month time period? Why is this important?
    Answer this question
    
Patients with an aneurysm that has documented enlargement in 6 months need to be referred for consultation with a vascular surgeon.

    (2006) 47 JAMECC 6 1239 



  • Were long-term follow-up evaluations advised? Why is this important?
    Answer this question
    
Patients undergoing endo-vascular aneurysm repair, require close lifelong follow-up.

    Click here for additional information at ClinicalKey.com 



  • Were follow-up evaluations advised? Why is this important?
    Answer this question
    
Routine follow-up evaluations are necessary to offset any complications that may arise.

    Click here for additional information at MD Consult.com 



  • Were imaging studies performed? Why is this important?
    Answer this question
    
CT is used to investigate possible complications of endo-vascular repair and to evaluate for graft infection.

    Click here for additional information at ClinicalKey.com 



  • Were the complications managed appropriately? Why is this important?
    Answer this question
    
Any patient in whom a post-operative complication is suspected must be referred emergently to a vascular surgeon.

    Click here for additional information at ClinicalKey.com