ABDOMINAL AORTIC ANEURYSM

The aorta is the main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes very large or balloons out. The exact cause of an aneurysm is unknown, but is thought to occur due to weakness in the wall of the artery. You have an increased risk of having an abdominal aortic aneurysm if you smoke, have high blood pressure, are male, and have a family history of the condition.

An abdominal aortic aneurysm is most often seen in males over age 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to break open or tear. An abdominal aortic aneurysm can be life-threatening.

Aneurysms can develop slowly over many years, often with no symptoms. Symptoms may appear quickly if the aneurysm expands rapidly, tears open or leaks blood within the wall of the vessel (aortic dissection). Symptoms of rupture include:

  • Pain in the abdomen or back. The pain may be severe, sudden, persistent, or constant. It may spread to the groin, buttocks, or legs.
  • Passing out
  • Clammy skin
  • Dizziness
  • Nausea and vomiting
  • Rapid heart rate
  • Shock

If you have any of these signs and symptoms, get immediate emergency help.

DIAGNOSIS

Abdominal aortic aneurysms are often an incidental finding during a routine check-up and routine medical tests (e.g. chest X-ray or ultrasound of the heart or abdomen).

To diagnose an abdominal aortic aneurysm, your doctor will perform a physical examination, ask about your symptoms and discuss your medical history. He will suggest one or more diagnostic tests. These include:

  • Abdominal ultrasound uses sound waves to produce pictures of the structures within the upper abdomen. This test is most commonly used to diagnose abdominal aortic aneurysms.
  • Computerized tomography (CT) scan  combines a series of X-ray images taken from different angles and uses computer processing to create cross-sectional images, or slices, of the aorta. It can detect the size and shape of an aneurysm.
  • Magnetic resonance imaging (MRI) uses a magnetic field and pulses of radio wave energy to create detailed images of internal organs. It is used to diagnose an aneurysm and determine its size and location.

 

TREATMENT

If you have bleeding inside your body from an aortic aneurysm, you will need surgery right away.

If the aneurysm is small and there are no symptoms, surgery is rarely done.You and your doctor must decide if the risk of having surgery is smaller than the risk of bleeding if you do not have surgery. Your doctor may want to check the size of the aneurysm with ultrasound tests every 6 months.

Most of the time, surgery is done if the aneurysm is bigger than 2 inches (5 centimeters) across or growing quickly. The goal is to do surgery before complications develop. There are two types of surgery:

  • Open repair: A large cut is made in your abdomen. The abnormal vessel is replaced with a graft made of man-made material.
  • Endovascular stent grafting: This procedure can be done without making a large cut in your abdomen, so you may recover more quickly. This may be a safer approach if you have certain other medical problems or are older adults. Endovascular repair can sometimes be done for a leaking or bleeding aneurysm.

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