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'''Rupture'''==Evaluation== ===Size classification==={{Diameters of abdominal aorta}}Abdominal aortic aneurysms are commonly divided according to their size and symptomatology. An aneurysm is usually defined as an outer aortic diameter over 3 cm (normal diameter of the aorta is around 2 cm),<ref name=ACC2005>{{cite journal |vauthors=Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B | title = ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)—summary of recommendations | journal = J Vasc Interv Radiol | volume = 17 | issue = 9 | pages = 1383–97; quiz 1398 | date = September 2006 | pmid = 16990459 | doi = 10.1097/01.RVI.0000240426.53079.46 }}</ref> or more than 50% of normal diameter.<ref name="SolomonKent2014">{{cite journal|last1=Solomon|first1=Caren G.|last2=Kent|first2=K. Craig|title=Abdominal Aortic Aneurysms|journal=New England Journal of Medicine|volume=371|issue=22|year=2014|pages=2101–2108|issn=0028-4793|doi=10.1056/NEJMcp1401430|pmid=25427112}}</ref> The suprarenal aorta normally measures about 0.5 cm larger than the infrarenal aorta.<ref>{{cite web|url=https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-abdominal-aortic-aneurysm|title=Clinical features and diagnosis of abdominal aortic aneurysm|author=Jeffrey Jim, Robert W Thompson|website=[[UpToDate]]|date=2018-03-05|deadurl=no|archiveurl=https://web.archive.org/web/20180330212246/https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-abdominal-aortic-aneurysm|archivedate=2018-03-30|df=}}</ref> === Signs of rupture ===
'''Imminent ===Signs of imminent rupture'''===
Templated
Because it is a widely available, rapid imaging method, computed tomography (CT) angiography is the exam of choice in such cases.<ref name="CorrêaAlves2019">{{cite journal|last1=Corrêa|first1=Ingrid Braga|last2=Alves|first2=Bruna Leal Torres|last3=Oliveira Sobrinho|first3=Tarcísio Angelo de|last4=Ramos|first4=Laura Filgueiras Mourão|last5=Diniz|first5=Renata Lopes Furletti Caldeira|last6=Ribeiro|first6=Marcelo Almeida|title=Abdominal aortic aneurysms that have ruptured or are at imminent risk of rupture|journal=Radiologia Brasileira|volume=52|issue=3|year=2019|pages=182–186|issn=1678-7099|doi=10.1590/0100-3984.2017.0096}}</ref>
== Findings Planning==Early identification {{Abdominal aneurysm - Choice of imaging findings indicating the rupture or imminent risk of rupture of an AAA can change the prognosis and ensure more appropriate treatment.<ref name="CorrêaAlves2019"/>modality}}
* Retroperitoneal hematoma (most common): translates to a loss of aneurysmal wall integrity and appears on CT as a periaortic focus of soft-tissue density. The hematoma can extend into the pararenal and perirenal spaces, as well as to the psoas muscle and into the intraperitoneal space. In contrast-enhanced images, active extravasation of the contrast agent can be seen.<ref name="CorrêaAlves2019"/>
* [[Draped aorta sign]]: in cases of a ruptured aneurysm contained, neighboring structures such as the vertebral bodies or adjacent retroperitoneal tissues buffer the hemorrhage and the patient may remain hemodynamically stable(1). A CT scan of a contained rupture can show the draped aorta sign, in which neither the posterior wall of the aorta nor the periaortic fat plane is distinguishable.<ref name="CorrêaAlves2019"/>
* The maximum diameter and growth rate of an aneurysm are the most common predictors of its rupture, underscoring the importance of serial imaging in the follow-up of patients with an AAA. In most cases of typical fusiform aneurysms, a surgical approach is indicated if the aneurysm diameter is > 5.4 cm or the aneurysm grows by more than 5 mm over a six-month period.<ref name="CorrêaAlves2019"/>
