SAN FRANCISCO-ER patients with apparent renal colic or even degenerative joint disease may be masking an abdominal aortic aneurysm.
Ruptured or leaking aneurysms were misdiagnosed or went undiagnosed for as long as four hours in 16 of 53 patients over a year at Methodist Hospital of Indiana’s ER.
Four patients at the Indianapolis center were initially thought to have renal colic, two cholelithiasis, two degenerative joint disease, two back injury, two constipation, one abdominal pain, and one weakness, says Dr. Jassi Johar. Two were undiagnosed after four hours.
Symptoms didn’t differ significantly between patients with correct and incorrect diagnoses, he told the American College of Emergency Physicians meeting here, but 74% of the first group had a palpable abdominal mass, vs. 30% of those who were misdiagnosed. Survival to discharge was 65% among those diagnosed quickly but 50% if diagnoses took longer.
