An abdominal aortic aneurysm is an excessive widening of the diameter of the abdominal aorta. The larger the diameter, the greater the risk of an aneurysm rupture, which can lead to hemorrhage, shock, and death. However, early diagnosis and treatment as well as proper care give a favorable prognosis. What are the causes and symptoms of an abdominal aortic aneurysm? What is the treatment?

Aneurysm of the abdominal aortameans widening of the diameter of the abdominal aorta by at least 50 percent. The aorta is the main artery that supplies blood to the entire body. It runs from the left ventricle of the heart through the chest and down to the abdominal cavity, where it splits into two common iliac arteries. Abdominal aortic aneurysm is located between the diaphragm and the exit of the common iliac arteries. How does it come about? The wall of each artery consists of several layers. If one of these layers weakens for any reason, the artery may widen and a pouch-like bulge called aneurysm may appear.

Aneurysm of the abdominal aorta - causes and risk factors

  • genetic factors such as Marfan syndrome or Ehlers-Danlos syndrome and family predisposition
  • atherosclerosis
  • smoking
  • hypertension
  • obstructive pulmonary disease
  • coronary artery disease
  • chronic ischemia of the lower limbs
  • abdominal hernia
  • age - the risk increases with age and is highest in people over 65
  • male gender (abdominal aortic aneurysms are found 3 to 8 times more often in men than in women)

Aneurysm of the abdominal aorta - symptoms

  • Asymptomatic aneurysm- shows no symptoms. Occasionally the patient may feel full after a meal or have stomach ache and sometimes throbbing in the abdomen.
  • Symptomatic aneurysm- gives symptoms such as:
    • back pain in the sacro-lumbar region (may be confused with sciatica)
    • pains in the lower abdomen that radiate to the thighs, bladder, perineum, testicles
    • swollen legs (or only one leg)
    • hematuria (it is the result of the aneurysm pressing on the ureter)
    • weight loss
  • Aneurysm ruptured- when perforation occursan aneurysm, there is a sudden pain in the lumbar region radiating towards the lower abdomen or perineum. Accompanying symptoms are vomiting (may be bloody) and visual disturbances. Limb paresis or paralysis, balance disorders or sensory disturbances, loss of consciousness may also occur.
Worth knowing

Risk of aneurysm rupture

The risk of an aneurysm rupture increases with its diameter. Aneurysms up to 5 cm in diameter rupture in 5-23 percent. sick. When the diameter is greater than 7 cm, perforation occurs in 60-80%. cases during the year.

Aneurysm of the abdominal aorta - examinations

The basic examination that allows to detect an abdominal aortic aneurysm and determine its diameter is an abdominal ultrasound. If the diameter of the aneurysm at the level of the renal arteries cannot be determined, computed tomography is performed. If your aneurysm is accompanied by symptoms of lower limb ischemia, you may need to undergo an arteriographic examination.

Worth knowing

The risk of an abdominal aortic aneurysm is especially high in men around the age of 65

Men around the age of 65 with unusual abdominal and lumbosacral pain should be examined for an abdominal aortic aneurysm.

It's good to know that the United States and the United Kingdom have introduced diagnostic screening programs for abdominal aortic aneurysms (using ultrasound examinations) in men over 65 years of age.

Abdominal aortic aneurysm - treatment

In the event of an aneurysm rupture, immediate surgery is required, which involves implanting a vascular prosthesis - usually the so-called aortic-aortic. After the abdominal cavity is opened, clamps are placed over the iliac artery and the aorta. Then, the aneurysm located between the clamps is cut vertically and a vascular prosthesis is sewn into its lumen, which, after removing the clamps, is sewn around with the aneurysm bag.

Patients with aneurysms larger than 4.5 cm are scheduled for surgery at a later date. However, contraindications for surgery are age over 85 years, acute coronary artery disease, circulatory failure, dyspnoea at rest, renal failure, liver cirrhosis, coagulation disorders, advanced neoplastic disease.

In some cases, an endovascular procedure can be performed, involving the implantation of a prosthesis / stent graft into the lumen of the aorta without the need to open the abdominal cavity.

Patients with aneurysms smaller than 4.5 cm require observation and ultrasound control every 3-6 months.

Aneurysm of the abdominal aorta - complications

After the operationcomplications such as: respiratory failure, circulatory failure, heart attack, gastrointestinal bleeding, acute renal failure may occur.

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Cardiology