Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Escalate
Sudden severe abdominal or back pain, collapse, hypotension or a tender/pulsatile abdominal mass may represent leaking or ruptured AAA: call the vascular team immediately, activate major-haemorrhage/resuscitation pathways and do not delay transfer for non-essential tests.
Synopsis
Recognise, measure and safely route abdominal aortic aneurysm in UK practice, including NHS screening, surveillance and repair thresholds.
AAA is an abdominal aortic diameter of 3.0 cm or more; most are asymptomatic until found by screening or incidental imaging.
In England, men are invited for one-off ultrasound in the screening year in which they turn 65; men older than 65 who have never been screened can self-refer.
Screening surveillance is annual for 3.0–4.4 cm and every 3 months for 4.5–5.4 cm aneurysms.
Key red flags
Symptomatic intact AAA
Persistent abdominal or back pain, focal tenderness or a new pulsatile sensation in a person with an AAA requires urgent vascular assessment.
Investigation priorities
01
Abdominal ultrasoundFirst step
Confirm and measure AAA without radiation or contrast.
Management branches
emergencySuspected ruptured or symptomatic AAA
Sudden severe abdominal/back pain, collapse, shock, tenderness or new pain over a known AAA.
First: ABC resuscitation, two large-bore IV lines, bloods/crossmatch, analgesia and immediate senior vascular/anaesthetic contact.
Next: arrange direct transfer to a vascular centre; use CTA only if sufficiently stable and it will change immediate operative planning.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.