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A To Z Disease Directory / 22 May 2019

ABDOMINAL AORTIC ANEURYSM

ABSTRACT -

An abdominal aortic aneurysm is a protuberance or swelling in the aorta, a blood vessel which runs from the heart down through the chest and abdominal. As the aneurysm grows larger, it mostly burst or ruptures which causes intense abdominal or back pain, nausea or shortness of breath. It develops slowly over years and doesn’t give any noticeable symptoms. There are two locations of aortic aneurysms, one is in the chest that is thoracic aortic aneurysm and the other is in the abdomen known as abdominal aortic aneurysm.

CAUSES -

An aneurysm can happen in any part of the body. Blood pressure can more easily swell a weakened arterial wall.

  1. Aortic dissection – It is identifiable cause of an aortic aneurysm. By splitting the layers of arterial wall, blood can burst through a tear in the weakened wall of the artery. It often reacts in sudden and excruciating chest pain.
  2. Infection in the aorta – This happens in rare cases, it weakens the part of the aortic wall which is caused by an infection or inflammation.
  3. Tobacco use – Cigarette smoking and other forms of tobacco increases the risk of aortic aneurysms which directly affects the arteries. Smoking accelerates the fatty plaques and high blood pressure in the arteries.
  4. Hardening of the arteries – Also called Atherosclerosis, occurs when fat and other substances build up the walls of the arteries and increases the risk of an aneurysm.

SIGNS AND SYMPTOMS -

Most aneurysms have no symptoms unless they rupture. If an AAA does rupture, following are the symptoms:
  • Shock or loss of consciousness
  • Clammy or sweaty skin
  • Increased heart rate
  • Sudden pain in abdomen or back
  • Pain spreading from abdomen or back to pelvis, legs, or buttocks

DIAGNOSIS -

It is generally identified through ultrasound examinations, X-rays or CT scans:
  • Abdominal Ultrasound (US): Doppler ultrasound technique enables to measure the exact size of an aneurysm which examines the blood flow through the aorta.
  • Abdominal and pelvic Computed Tomography (CT):It is highly accurate in measuring the size and extent of aneurysm.
  • Angiography: It uses X-rays, CT or MRI to view the pictures of major blood vessels of the body.

TREATMENT -

The wall of the aorta becomes weaker and weaker as aneurysm grows in size, then surgical intervention is needed.
    1. Surgical treatment – This treatment is done in asymptomatic abdominal aortic aneurysms which do not require surgical intervention until they grow in size over a certain period of time.
    2. Small and medium AAA - Treatment is not needed if the size of AAA is small or medium of about 1.6-4 inches. Regular ultrasound scans is done to check if aneurysm is getting bigger in every 6-12 months.
    3. Large AAA – Surgery is needed if you have a large AAA which is done through piece of man-made tubing for complicated surgery.
Types of surgery for an AAA:
      • Endovascular surgery – The graft is inserted into a blood vessel in the groin through small cuts made in the skin and then carefully passed up into the aorta.
      • Open surgery – In this, a cut is made in the abdomen and surgeon replaces the affected section of aorta with a graft. The surgery is done under general anesthetic conditions.

EPIDEMIOLOGY -

  • It is estimated that prevalence of AAA is 2–7% among males in the age group of 50 years and 1% among females older than 65 years, with decreasing values in younger generations.
  • The commonness of AAA is defined as a maximal infrarenal aortic which indulge 8.2 percent and 1.7 percent in men and 2.3 percent and 0.4 percent in women.

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