How frequently is nephrolithiasis misdiagnosed as abdominal aortic aneurysm (AAA)?

Updated: Jun 21, 2018
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Failure to diagnose or delay in diagnosing symptomatic AAA may lead to medicolegal liability. The pain of a leaking AAA often is misdiagnosed initially as renal colic. In one series of 134 patients with symptomatic AAA presenting to the ED, the following statistics were reported [20] :

  • Eighteen percent had an initial misdiagnosis of nephrolithiasis.

  • All were older than 60 years and none had a prior history of renal calculi.

  • Eighty percent had a pulsatile mass noted by at least one examiner.

  • Forty-three percent had microhematuria on urinalysis.

  • Delay of diagnosis of AAA in the ED was associated with higher mortality and morbidity rates than in the group who received the correct diagnosis promptly.


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