Clinical Diagnosis and Management
R. Cates, DC, FACO
200 North 6th Street
Oregon, IL 61061
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Journal of Manipulative and Physiological Therapeutics - Vol 20, Number 8, Oct. 1997; Pgs 557-561
Objective: To review the presentation, diagnosis and management of aneurysms of the aorta in a chiropractic office. Case reviews and a brief topic review are presented.
Clinical Features: Three cases of aneurysm that were diagnosed in a chiropractic office are discussed. An aneurysm is defined as an abnormal dilation of the aorta as a result of artherosclerosis, genetic predisposition and/or acquired biochemical alterations in the wall of the aorta. The "classic triad," hypo-tension, back pain, and a pulsatile abdominal mass are present in only 50% of those people with ruptured abdominal aortic aneurysms (AAA). Large unruptured aneurysms are quite often asymtomatic and are often found incidentally on physical or X-ray examination. History, palpation, auscultation and imaging are all helpful in diagnosing AAAs, and all are readily available in a chiropractic office.
Intervention and Outcome: Surgical intervention is generally considered appropriate in AAAs > 5 cm in diameter. All Patients recovered after surgical repair of the aneurysm.
Conclusion: Chiropractors can perform simple diagnostic procedures to differentially diagnosis and screen for AAAs. Such screening measures may yield a statistical decrease in deaths caused by rupture of aortic aneurysms.
Key Indexing Terms: Abdominal aorta, Aneurysm, Low back pain, Chiropractic, Differential Diagnosis