[Aneurysms of the abdominal aorta. Value and mode of detection]

Despite improvements in the treatment of risk factors for atherosclerosis, the incidence and mortality rate for aneurysms of the abdominal aorta have increased during the past 40 years. The prevalence of these aneurysms is 2.5 percent in unselected populations but reaches 13.5 percent in selected populations. The pathogenesis of aneurysms involves multiple factors and the lesion is progressive, leading to lethal rupture in 25 percent of the cases. In elective surgery of abdominal aortic aneurysms the mortality rate is about 2 percent, as against 60 percent in emergency surgery for rupture. The presence of such aneurysms must be detected primarily in populations at risk, using physical examination and abdominal ultrasonography. If this is done, the ratio of detection costs to benefits of preventive surgery is in favour of a decidedly active approach of this dangerous disease.