Abdominal aortic aneurysm
Abdominal Aortic Aneurysm - Definition, Description, Causes and Risk Factors:
Abdominal aortic aneurysm (short AAA) is a ballooning of the aorta, the largest blood vessel in the human body, which extends into the abdomen. If the wall of this blood vessel becomes weakened, it can stretch, "balloon" out and rupture.
Abdominal aortic aneurysm is a relatively common and often fatal condition that primarily affects older patients. Abdominal aortic aneurysm is the 10th leading cause of death in white men 65 to 74 years of age in the United States. With an aging population, the incidence and prevalence of abdominal aortic aneurysm is certain to rise.
A healthy abdominal aorta has a diameter of 2-3 cm (one inch). If an aneurysm develops, the diameter of the aorta increases. The increase in diameter weakens the walls of the aorta, increasing the risk of the aorta rupturing (splitting).
A ruptured aortic aneurysm can cause significant internal bleeding and requires prompt emergency surgery. Mortality from ruptured abdominal aortic aneurysm is extremely high. It is estimated that around 85% of people with a ruptured aneurysm will die, and that many of these will die before reaching a hospital. Even for those who reach hospital alive, around 30-75% of people with ruptured aortic aneurysm will die as a result.
Abdominal aortic aneurysm - Causes and risk factors:
- High blood pressure.
- High cholesterol.
- Male gender.
- Genetic factors.
- Smoking is a major risk factor for abdominal aortic aneurysm .
- Drugs, eg, corticosteroids, chemotherapy.
- Recent abdominal surgery.
- Penetrating or blunt abdominal trauma.
- Perforation of appendix or colonic diverticulum.
- Perforation associated intra-abdominal malignancy.
- Crohn's disease.
- Chronic diseases, eg, cirrhosis, renal failure.
- Prior radiotherapy.
Aneurysms develop slowly over many years and often have no symptoms. If an aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel (aortic dissection), symptoms may develop suddenly.
The symptoms of rupture include:
Pain in the abdomen or back -- severe, sudden, persistent, or constant. The pain may radiate to the groin, buttocks, or legs.
- Clammy skin.
- Rapid heart rate
- Nausea and vomiting.
Atheroembolism to lower extremities.
- Thrombosis (sudden severe ischemia of legs).
- High output CHF from aortocaval fistula.
- GI bleeding from primary aortoenteric fistula.
- Ruptured abdominal aortic aneurysm.
- Pulsatile mass plus hypotension.
- Abdominal/back/groin pain plus hypotension.
Your doctor will examine your abdomen. The exam also will include an evaluation of pulses and sensation in your legs. The doctor may find:
- Stiff or rigid abdomen.
- Pulsating sensation in the abdomen.
Imaging Tests May Include:
Ultrasound for screening.
- CT scan is the best test for aneurysms being considered for repair.
- Conventional MRI has no advantage over CT for abdominal aortic aneurysm.
- Angiography is not used for diagnosis (can miss abdominal aortic aneurysm due to normal lumen).
Most abdominal aortic aneurysms are asymptomatic. It is important that family physicians understand which patients are at risk for the development of abdominal aortic aneurysm and the appropriate evaluation once a patient has been diagnosed with an aneurysm.
If the aneurysm is small and there are no symptoms you and your doctor must decide whether the risk of having surgery is smaller than the risk of bleeding if you do not have surgery. Your doctor may recommend checking the size of the aneurysm with a yearly ultrasound test, to see if the aneurysm is getting bigger.
Surgery is usually recommended for patients who have aneurysms bigger than 2.0 inches or 5.5 cm across and aneurysms that are growing quickly. There are two approaches to surgery:
In a traditional (open) repair, a large cut is made in your abdomen. The abnormal vessel is replaced with a graft made of man-made material, such as Dacron.
- The other approach is called endovascular stent grafting. This procedure can be done without making a large cut in your abdomen, so you may get well faster. Endovascular repair is rarely done for a leaking or bleeding aneurysm.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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