Abdominal Aortic Aneurysm - Causes, Symptoms & Treatment

Abdominal Aortic Aneurysm is often called a "silent killer" because there are usually no obvious symptoms of the disease. Aneurysms are more common in older people and in men. A family history of AAA is a risk factor for AAA. Aortic aneurysms can develop anywhere along the length of the aorta. The majority, however, are located along the abdominal aorta. Most (about 90%) of abdominal aneurysms are located below the level of the renal arteries, the vessels that leave the aorta to go to the kidneys. an abdominal aortic aneurysm ruptures (bursts) it can be fatal.

Surgery can repair the aorta - this can be emergency surgery if the aneurysm ruptures or elective (planned) surgery if a patient has an aneurysm that is large and the risk of rupture is high. An aneurysm (say: an-yur-izm) is a weak area in a blood vessel. If a blood vessel weakens, it starts to swell like a balloon. If the aneurysm grows too large, your aorta may tear or burst. Although about 20% of people with abdominal aortic aneurysms have a close relative with the same problem, no clear genetic link has been found.

The family connection seems to be particularly strong among brothers. Most aortic aneurysms occur in the section of the aorta that passes through the abdomen and are called abdominal aortic aneurysms. A few occur in the part of the aorta in the chest that is near the heart, and are called thoracic aortic aneurysms.

Aneurysms are defined as a focal dilatation with at least a 50% increase over normal arterial diameter. The inciting factors are not known, but a genetic predisposition clearly exists. As the wall of the aneurysm is weaker than a normal artery wall it may not withstand the pressure of blood inside. This may cause it to rupture (burst). Aortic aneurysms are most often caused by damage to the artery's wall due to atherosclerosis, commonly known as hardening of the arteries. Atherosclerosis is caused by a buildup of cholesterol and other fatty deposits in the arteries and by hypertension (high blood pressure). The two types of aortic aneurysms are abdominal aortic aneurysm and thoracic aortic aneurysm.

Abdominal Aortic Aneurysm arise as a result of a failure of the major structural proteins of the aorta (elastin and collagen). Normally, the aorta is about one inch (2.5 centimeters) in diameter. The size increases very gradually as people age. If the abdominal section of the aorta becomes larger than 3 centimeters, the person is said to have an abdominal aortic aneurysm. Abdominal aortic aneurysms can be diagnosed from their symptoms when they occur. They may also be found on routine physical examination and chest and abdominal X-rays.

Causes of Abdominal Aortic Aneurysm

The exact cause is not fully known. At least 80% of aortic aneurysms are from arteriosclerosis. This is a condition in which fatty deposits are laid down in the walls of arteries. The deposit is called an atheroma. The wall of the aorta is very elastic and can normally stretch and then shrink back as needed to adapt to blood flow. However, some medical conditions-most commonly, hardening of the arteries (atherosclerosis) and high blood pressure -weaken the artery walls. Find common causes and risk factors of acne:

• Trauma to the aorta, for example a crush injury to the chest following a car accident
• Certain infections including syphilis
• Injury to the abdomen
• Peritonitis
• Acute appendicitis
• Gastrointestinal perforation
• Cholecystitis
• Marfan's syndrome

Signs and Symptoms of Abdominal Aortic Aneurysm

Most people have no symptoms. Aneurysms often are discovered during routine physical exams or during X-rays for unrelated illnesses. Persons with AAAs that have ruptured may present in many ways. The most typical manifestation of rupture is abdominal or back pain with a pulsatile abdominal mass. However, the symptoms may be vague, and the abdominal mass may be missed. Symptoms may include groin pain, syncope, paralysis, or flank mass. When the blood vessel walls start to leak or tear, you may feel pain in your back, stomach, buttocks, groin, testicle, or leg. In the worst case, an aneurysm can burst, or rupture, causing severe pain and bleeding. A ruptured aneurysm is a life-threatening condition, often leading to death within minutes. In about 20% of cases, an undiscovered abdominal aneurysm ruptures without warning, and the patient collapses and dies from massive bleeding inside the abdomen. Sign and symptoms may include the following :

• Pain in the abdomen, back or the fleshy part of your sides between the bottom of your ribs and your hips
• A feeling of fullness after eating a small meal
• Nausea and vomiting
• A pulsating mass in the abdomen

Treatment for Abdominal Aortic Aneurysm

The treatment options for asymptomatic AAA are immediate repair, surveillance with a view to eventual repair, and conservative . Surgery is needed for large or fast-growing aneurysms, or when symptoms are present. Typically the damaged portion of the blood vessel is replaced with a man-made graft. It is important to stop the aneurysm from bursting. Preoperatively, obtain a careful history and perform a physical examination and laboratory assessment. From the information derived from these basic assessments, perioperative risk and life expectancy after the proposed procedure can be estimated. You can help by quitting smoking and by working with your doctor to control your blood pressure and cholesterol. Even with no symptoms, a person with an aneurysm larger than 6.5 centimeters would almost always have emergency surgery to repair the problem. Younger and generally healthier patients are probably better served with abdominal surgery, although this may change as endovascular devices and techniques improve.

Diagnostic tests that may be performed include the following:

• Blood tests
• Urine tests
• Colonoscopy
• Gastroscopy
• Peritoneal lavage
• Stool studies
• X-ray of the chest
• X-ray of the abdomen

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