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June 2, 1999

Illness and Culture

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(21):1989. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-21-jbk0602

In Reply: We agree with Dr Callis that patients with abdominal pain and shock should be taken directly to the operating room. However, many patients with ruptured AAAs have a more subtle presentation, and, in these cases, diagnostic confirmation is often necessary.1 Our intention was to emphasize that once a ruptured AAA is suspected, physical examination alone should not be relied on to exclude the diagnosis.

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