Possible Hurnia or tripple AAA?

[PCP]

Had a patient the other night that had mass located in the center of her abdomen and when she would sit up the mass would protrude outward but when lying down the mass would go away?

Vitals signs stable besides the BP which was 220/72 and clammy skin which I figured was due to the high BP.

No other complaints besides the mass in her abdomen. My parnter mentioned she thought she could possibly feel a pulsating mass on palpation but was not 100% sure.

My partner and I thought possible tripple AAA or Hurnia?

No 12 lead capability just BLS level

Any thoughts on what may have been causing the mass in the abdomen and high blood pressure?

[DwayneEMTP]

Excellent question.

But instead of answering it straight away, let me ask you a couple of questions, ok? And researching them is fine if you need to.

When we talk about the possible solutions to this question, which I believe contains the answer, as you do, what two systems are we talking about?

If it is a AAA, what vessel are we talking about? Where does that vessel run? How is it attached in the body?

Why would I believe that 'my partner 'may' have felt a pulse in it' may be the answer to your question?

In no way am I trying to make you feel foolish with these questions, in fact, I love your question and believe it's really smart. But these are answers that you can find pretty easily (I checked) with Google, and I believe that you will look at future issues like this much differently if you choose to answer them.

I look forward to your thoughts man.....

Dwayne

[Vorenus]

Just a small question: have you checked peripheral pulses on the legs (dorsalis pedis, tibialis posterior) and radialis pulse?

[crotchitymedic1986]

It was most likely a hernia, if the mass is not pulsating, and the femoral artery pulse is not significantly weakened, it is probably not a AAA.

[Just Plain Ruff]

I have exactly the same thing this lady has but my BP is fine.

When I sit up the mass protrudes when I lie back, it goes away.

I was doing sit ups one day about a year ago and felt a tear in the abdomen. I went to the ER and they said that my abdominal muscles had separated like a split chicken breast. They said that with my weight (I'm down 13 pounds to around 300# as of this writing) it would be a very painful and dangerous surgery for me.

It looks scary but it's not a AAA or I'd be dead by now.

[ERDoc]

It was most likely a hernia, if the mass is not pulsating, and the femoral artery pulse is not significantly weakened, it is probably not a AAA.

Why would you have a weakened pulse with a AAA?

[PCP]

Excellent question.

But instead of answering it straight away, let me ask you a couple of questions, ok? And researching them is fine if you need to.

When we talk about the possible solutions to this question, which I believe contains the answer, as you do, what two systems are we talking about?

If it is a AAA, what vessel are we talking about? Where does that vessel run? How is it attached in the body?

Why would I believe that 'my partner 'may' have felt a pulse in it' may be the answer to your question?

In no way am I trying to make you feel foolish with these questions, in fact, I love your question and believe it's really smart. But these are answers that you can find pretty easily (I checked) with Google, and I believe that you will look at future issues like this much differently if you choose to answer them.

I look forward to your thoughts man.....

Dwayne

Okay Dwayne here I go! I am going to take a shot at this first of all without using " google" .

question #1 The two systems I was talking about are the " Circulatory system" and the " Gastrointestinal system"

question #2 If it is a AAA we would be talking about the " decending Aorta".

The vessel runs from the " Left Ventricle down through the abdomen and at the groin area it splits into two and feeds the left and right leg.

question #3 I am not sure about this question? If I can remember right the Aorta is attached to the Left Ventricle and with each contraction the " Mitral valve " opens and allows the blood to enter the " Aorta" which then goes up into the " Aortic Arch" and into the " Decending Aorta".

Not sure if that was the answer you wanted?

No worries Dwayne I understand that you are not attempting to make me feel foolish but to make me think!

Brian

Why would you have a weakened pulse with a AAA?

Not 100% sure on this question but I will give it a shot!

Weakened femoral pulses is due to the AAA bursting and the patient having internal bleeding which will cause the body to shunt the blood to the vital organs making the pulses below where the AAA has occured weaker?

[FireMedicChick164]

not to be critical or anything but my first thought was that someone needs to learn how to spell....the question was a good one though.

I will think more on this and then contribute an answer.

[DFIB]

I am gonna jump in with Dwayne on this one for a little while and do an virtual exploration of this lady's abdomen.

Here are some more questions

What does a hernia feel like under palpation?

What does a AAA feel like under palpation?

Is it possible for an AAA to bulge out the front of the abdomen?

If there were an AAA what vital signs would you expect?

What would possibly pertrude when abdominal pressure is increased by changing position?

What would be more urgent, the bulge or the BP?

[PCP]

not to be critical or anything but my first thought was that someone needs to learn how to spell....the question was a good one though.

I will think more on this and then contribute an answer.

Yes I agree I am not the best speller and I do need to work on my spelling. I don't take your comment about spelling personal just as a reminder to double check my spelling before posting.

Thank you