An aneurysm is an atypical enlargement of the vessel, which is most often formed in the aorta. As a rule, the site where this pathology appears is the area of the weakened vessel wall, which, in addition, is further expanded under the influence of high blood pressure.
If aneurysms are not diagnosed at an early stage and do not undergo treatment, their rupture may occur, leading to extensive internal bleeding and, often, death.
In addition to the risk of aneurysm rupture, pathology is dangerous because blood flow is disturbed in the damaged vessel, and this often leads to the formation of clots - blood clots, which also leads to serious health problems.
Aneurysms can form in any of the aortic areas, but the most common is a pathological change in the abdominal part of the aorta.
- 1 Reasons for
- 2 Symptoms
- 2.1 Primary
- 2.2 Progressive
- 2.3 Signs of rupture
- 3 When to contact a specialist?
- 4 Diagnosis
- 5 Treatment methods
- 5.1 Traditional operation
- 5.2 Endovascular method
- 6 Forecasts
The most common cause of aneurysm of the abdominal aorta( about 80% of all cases) is atherosclerosis.
Also causes abdominal aortic aneurysms are:
- hereditary factor;
- some genetic diseases of connective tissues;
- trauma of the aorta;
- inflammatory diseases of the arteries;
- fungal infections associated with HIV / AIDS, syphilis, as well as with operative methods of treating cardiac valves.
It happens that the size of an aneurysm is small and remain so for a long time. Aneurysms of the abdominal aorta usually grow at a slow rate, and as a rule, the course of the disease is asymptomatic.
Rarely, the disease can be identified at an early stage, only based on the symptomatology - the detection of pathology occurs in examinations related to other diseases. However, the symptoms of education are sometimes present and it is important to be able to recognize them.
A typical clinical symptom of an abdominal aortic aneurysm is tenderness in the left side of the abdomen, or mesodastrium .Pain can be permanent or episodic.
- pulsation around the navel;
- feeling of heaviness in the abdomen;
- disruption of the digestive system( constipation, flatulence, nausea, etc.).
With the growth of an aneurysm, specialists note the appearance of progressive symptoms, which include:
- Urological syndrome , which is manifested by disorders of urination, the presence of blood in the urine. A symptom develops due to compression of the ureter or displacement of the kidney.
- Ishioradicular complex of symptoms , which is characterized by pain in the lumbar region, impaired motor abilities and sensitivity in the legs. A similar condition is associated with pressure on the vertebrae or nerve roots of the spinal canal.
- Ischemia of the lower extremities , which is manifested by lameness, trophic disorders.
Signs of Gap
Symptoms of rupture of the abdominal aortic aneurysm, which requires immediate treatment, are as follows:
- sharp pain in the abdominal and lumbar regions;
- acute vascular insufficiency( collapse);
- strong pulsation in the abdomen.
Aneurysm rupture can be directed beyond the peritoneum, into the free cavity of the peritoneum, into the bladder, duodenum, or inferior vena cava. All this manifests itself in different ways:
- The retroperitoneal rupture of .For this type of rupture is characterized by a strong permanent pain, which can irradiate into the thigh, groin, and perineum. Sometimes there are pains in the region of the heart.
- Rupture of the peritoneum .For such a pathology is characterized by a massive accumulation of blood in this cavity, which leads to a rapid development of hemorrhagic shock - pallor of the skin, cold sweating, severe weakness, filiform, rapid pulse, hypotension. Often an aneurysm rupture directed to this area leads to the patient's death.
- Rupture in the duodenum .This type of rupture is characterized by gastrointestinal bleeding, bloody vomiting, black liquid stools. This variant of the rupture is very difficult to distinguish from gastrointestinal bleeding caused by a number of other causes.
- A rupture in the inferior vena cava .This development of the disease is accompanied by tachycardia, severe weakness, shortness of breath. Also, the condition is characterized by swelling of the legs. Pain in the abdomen and waist, pulsating neoplasm in the peritoneum develop gradually, which leads to acute heart failure.
More details about the disease look at the video:
When to contact a specialist?
If any of the primary signs of an aneurysm of the abdominal aorta are present, it is necessary to urgently consult a specialist.
People older than 60 years and older, and especially those who have the risk factors pathology, you need to regularly visit a doctor and undergo the necessary examination to determine the presence of an aneurysm.
Smoking men aged 65 to 75 years need to undergo a one-time ultrasound examination of the abdominal cavity every year. Such a survey is conducted for men with a family history of pathology.
You can confirm or deny the presence of an aneurysm of the abdominal aorta by going through special studies of :
- ultrasound of the abdominal cavity;
- CT of the aorta;
- MRI of the aorta.
Differential diagnosis is a method by which all possible diseases that are not suitable for symptoms or other factors are excluded. As a result, the diagnosis is reduced to one single possible disease. Diagnosing the disease is difficult enough for , especially if its course is asymptomatic, or if symptoms of peritoneum and retroperitoneal space predominate.
There is no medication for this disease. Basically, surgical intervention is performed, but if the aneurysm reaches small dimensions( up to 6 mm), the course is asymptomatic( or the symptoms do not interfere with the full life), then the method can be offered to the patient "active waiting" for .This method consists of regular behavior of ultrasound and monitoring of the patient's condition.
The reason for the operation is an aneurysm with a size of more than 6 cm or a growth rate of more than 5 mm in six months .The operation is performed also in those cases when the aneurysm began to bleed, as well as with pronounced painful syndromes and progressive symptoms.
There are 2 methods of conducting an operation.
In this operation, the patient is under general anesthesia. The surgeon makes an incision from the sinuous process of the sternum to the navel.
The damaged area of the vessel is excised , and in its place an artificial prosthesis( Graft) is implanted.
The procedure lasts 3-5 hours .The period of postoperative hospital stay is about a week.
In the endovascular procedure, , a special device ( Stent-Graft) is implanted in the injury site, which helps restore the structure of the aorta and the blood flow in it.
The procedure is usually performed by using epidural anesthesia .The surgeon makes a small puncture in the groin area, through which a stent-graft is fed to the aneurysm using a special catheter. After bringing the device to the designated place, the surgeon opens it and places it in an aneurysmal area. After the opening of the stent-graft, a channel is formed, along which the normal movement of blood occurs.
With the obvious advantages of the method, it does not fit to every patient .For example, the introduction of a stent-graft is not possible for patients with pathological diseases of the arteries and some organs. It should be noted that the effect of the procedure can be short-lived, which leads to the need for a repeat operation.
Sadly, forecast unfavorable .Within 36 months from the moment of aneurysm rupture, almost all patients die. With small aneurysms of the abdominal aorta, the survival rate in the first year is 75%, and for 5 years - 50%.If the aneurysm is greater than 6 cm, the indices are reduced to 50% and 6%, respectively.
Aneurysm of the abdominal aorta - is an insidious and unpredictable disease .The growth of an aneurysm can not be predicted, so it is so important to consult a specialist with the first symptoms, and also undergo a regular medical examination.