1. Home>
2. Specialties>
3. Cardiology>
4. Summary and Comment

Palpation Useful in Detecting Abdominal Aortic Aneurysms

To assess the value of abdominal palpation for diagnosing abdominal aortic aneurysms (AAA), this timely review examines 15 studies of patients not previously known to have AAA who were screened both with palpation and ultrasound. The 15 reports were published from 1983 through 1996 and represent a pooled group of nearly 3,000 patients.

In the 15 individual studies, the positive predictive value of palpation among patients with asymptomatic aneurysms varied from a low of 14 percent to a high of 100 percent. In the pooled analysis, the positive predictive value was 43 percent, while sensitivity of abdominal palpations was 29 percent for aneurysms between 3 and 3.9 cm in diameter, 50 percent for aneurysms from 4 to 4.9 cm, and 76 percent for aneurysms 5.0 cm or larger. Among nine studies that examined whether palpation identified ruptured AAAs, sensitivity varied from 44 percent to 97 percent. Obesity appears to limit the accuracy of abdominal palpation.

Comment: This clinical review supports the use of careful abdominal palpation to identify asymptomatic or symptomatic AAAs. Among aneurysms large enough to warrant surgery, sensitivity increases to 76 percent, although it may be lower in obese patients. These data also suggest that in the absence of abnormal physical findings on palpation, suspected rupture of an abdominal aortic aneurysm should be pursued vigorously with imaging techniques.

— KA Eagle

Published in Journal Watch Cardiology March 20, 1999

Citation(s):

Lederle FA and Simel DL. Does this patient have abdominal aortic aneurysm?. JAMA 1999 Jan 6 281 77-82.

• Original article (Subscription may be required)
• Medline abstract (Free)