<prompt> A smoker patient presents with abdominal aortic aneurysm with diameter of 44 mm with non-specific abdominal pain what is the ideal answer below?Immediately operateOperate when size becomes 55 mm diameterSerial USG advised until it becomes 77 mm DiameterNo treatment needed.  <response>: Abdominal Aortic Aneurysm 95 aneurysms are infra renal Most common Type of Larger Vessel Aneurysm and is found in 2 population at autopsy. MC cause is Atheromatous degeneration MC symptom - Back and Abdominal Discomfort Site of rupture: Mc site postero lateral 80 2nd mc site anterior 20 Less than 50 per cent of patients with rupture survive to reach hospital. Anterior rupture results in free bleeding into the peritoneal cavity; very few patients reach hospital alive. Posterior rupture on the other hand produces a retroperitoneal hematoma Ruptured abdominal aortic aneurysm is a surgical emergency; it should be suspected in a patient with the triad of severe abdominal andor back pain, hypotension and a pulsatile abdominal mass Bailey and Love says It should always be remembered that the treatment of ruptured aneurysm is operation, not monitoring and resuscitation.Indications for Surgery All symptomatic aneurysm mc symptom is back and abdominal discomfort Aneurysms size greater than 55 mm on USG antero-posteriorly. Aneurysms 55 mm in diameter needs Regular USG assessment. 