Abdominal aortic aneurysm

Causes and Risks:
Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. The exact cause is unknown, but risks include atherosclerosis and hypertension . Some causes of an abdominal aortic aneurysm are injury, infection, or congenital weakening of the connective tissue component of the artery wall.

Abdominal aortic aneurysm can affect anybody, but it is most often seen in men 40 to 70 years old. A common complication is ruptured aortic aneurysm. This is a medical emergency where the aneurysm breaks open, resulting in profuse bleeding . Ruptured aneurysm occurs in approximately 5 out of 10,000 people. Aortic dissection occurs when the lining of the artery tears and blood leaks into the wall of the artery. An aneurysm that dissects is at even greater risk of rupture.

In children, abdominal aortic aneurysm can result from blunt abdominal injury or from Marfan's syndrome .

Prevention:
Avoid blunt trauma to the abdomen, atherosclerosis , and hypertension .

Symptoms:

Note: Aneurysms may develop slowly over many years and often have no symptoms. If the aneurysm expands rapidly, tears open (ruptured aneurysm), or blood leaks along the wall of the vessel ( aortic dissection ), the above symptoms may develop suddenly.

Signs and Tests:
Listening to the abdomen with a stethoscope ( auscultation ) shows a "blowing" murmur over the aorta or a "whooshing" sound (bruit). Physical examination of the abdomen is performed. If a rupture is suspected, physical examination for signs of blood loss ( hypovolemia ) and an evaluation of lower extremity pulses and circulation are performed.

Abdominal aortic aneurysm may show on these tests:

A CBC may indicate loss of blood.

Treatment:
If the aneurysm is small and there are no symptoms (for example, if the aneurysm is found during a routine physical examination ), periodic evaluation to watch for changes may be recommended.

Symptomatic aneurysms may require treatment to prevent complications. Antihypertensive medications may be prescribed to reduce blood pressure . Other medications may include analgesics to relieve pain.

Surgical repair or replacement of the section of aorta is often recommended. The goal of treatment is timely surgical intervention before complications develop.

The risk of complications increases as the size of the aneurysm increases. Because surgery for abdominal aortic aneurysm is risky, the surgeon may wait for the aneurysm to expand to a certain size before operating (that is, when the risk of complications exceeds the risk of surgery).

Prognosis:
The probable outcome is good when an aneurysm is monitored carefully and if surgical repair is performed before the aorta ruptures. Aortic rupture is life threatening. Less than 50% of all people with a ruptured abdominal aortic aneurysm survive.

Complications:



Call Your Healthcare Provider:
Go to the emergency room or call the local emergency number (such as 911) if you develop severe abdominal pain or other symptoms that are suggestive of an abdominal aortic aneurysm.


Aortic rupture (a tear in the aorta, which is the major artery coming from the heart) can be seen on a chest X-ray. In this case, it was caused by a traumatic perforation of the thoracic aorta. This is how the X-ray appears when the chest is full of blood (right-sided hemothorax) seen here as cloudiness on the left side of the picture.